Mass General Spine Service's Focus on Patient Outcomes

Stuart Hershman, MD, surgeon in the Orthopaedic Spine Center at Massachusetts General Hospital, discusses his collaborative research and clinical practice focused on patients with complex spinal deformities—specifically osteoporosis. Dr. Hershman is researching presurgical strategies for improving spine patient outcomes, and works with specialists across Mass General and globally to share data and improve clinical knowledge of successful spinal intervention strategies.

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Transcript

Some of the work that we're doing here at Massachusetts General Hospital in the Division of Spine Surgery focuses on patient outcomes, and my specific interests are in the treatment of patients with spinal deformity and complex spinal issues, and specifically, those patients who also have osteoporosis. Some of the problems with osteoporotic patients, in general, is that their outcomes tend to be worse than patients who do not have osteoporosis and certainly when we're doing complex spinal reconstruction, which is typically what we need to do in patients who have a spinal deformity, those patients tend to have worse outcomes. So a lot of the research that we're currently doing focuses on ways to try and improve those outcomes through pre-hab, preoperative optimization in terms of monitoring their bone density, getting patients on the appropriate anabolic treatments prior to surgery, nicotine cessation if appropriate, implementing vitamin D strategies, and optimizing their overall health and metabolic status prior to surgery through proper nutrition and counseling.

I hope that in the future as we move towards improving outcomes in spinal surgery that we see not just improved outcomes, but improved functionality, reduced disability and overall better success rates. That means reducing postoperative complications, reducing length of stay, reducing hardware instrumentation failures—and overall just seeing happier patients who are moving around better. Through the optimization of patient care both preoperatively and postoperatively, we can see patients with more successful outcomes who are back to their baseline status at a faster rate.

One of the things that makes doing research here at Massachusetts General Hospital so rewarding is that we have so many avenues at our disposal. We have a tremendous base as far as complexity of cases is concerned and we are able to collaborate with colleagues who are world experts in our field and also in other fields, and certainly, by having all of those people and resources, we really are able to make a change that happens a little faster than it would have if we were anywhere else. This is really a special place to do research.

Some of our colleagues in other fields are doing research that is either paralleling our research, similar to our research or can complement our research in other ways. For example, one of my colleagues in the Oncology Service is also studying the postoperative infection rates and using different products to try to bring down those infection rates. One of the problems that we have when we are doing complex spinal reconstruction is that infection rates tend to be a little bit higher than when we are doing other smaller procedures. By working with some of our colleagues on the Oncology Service, we are able to combine our data, combine our efforts and hopefully reach our answers and get our conclusions a little bit faster than if we were doing research by ourselves.

Learn more about the Orthopaedic Spine Center

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