How do we optimize spinal surgery outcomes? Dr. Steven Glassman believes better data is the answer! On this episode, we discuss the American Spine Registry, what it is, what it’s currently being used for, and its potential to provide better evidence for spine surgery, improve patient outcomes, and establish universal best practices.
You will want to hear this episode if you are interested in…
- Getting to know Dr. Glassman, his clinical practice, and why he chose spine research [0:59]
- Exploring the nature and necessity of registries [3:56]
- What is the American Spine Registry, what areas of spine surgery are represented by it, and how long has it been in place? [6:27]
- What areas of spine surgery are represented by the ASR? [13:24]
- The most surprising findings from studies based off of the Quality Outcomes Database [18:08]
- Predicting the future evolution of the ASR [21:35]
- Examining ASR logistics and how hospitals can join the registry [25:10]
- How the ASR can bring better clarity to spine surgery outcomes [28:28]
- Using the ASR to develop predictive models and the role imaging plays with the registry [30:50]
- Exciting future studies and the magic wand question [35:15]
Speed and efficiency
The American Spine Registry (ASR) is a database that reports on the patient outcomes of spine surgery. Sure, there are similar databases in other medical fields, but this collaborative effort between the American Association of Neurological Surgeons (AANS) and the American Academy of Orthopedic Surgeons (AAOS) has brought much-needed clarity to a field with mainly mixed results. The main hurdle to spine surgery optimization is that its outcomes differ on a case-by-case basis. If you’re looking at it from the ground, you can’t see the bigger picture. The ASR allows for medical professionals in standard clinical practices to easily sift through previous outcomes and come up with more efficient treatment plans based on past results of similar patients.
Diving into the data
Spine surgery data is much more complicated than other kinds of joint replacement data. There are many different diagnoses, even for a person with the same problem. Different procedures can also correct the same issue. Keeping all of that straight is the tedious task the ASR sets out to complete. Though it has been active for two years, the ASR has only accumulated data on its dashboard over the past six to eight months. Dr. Glassman and his team’s initial focus is collecting data from degenerative cervical and degenerative lumbar cases. Their next target will be metastatic tumors because they want to focus on something that’s taken care of broadly across orthopedics and neurosurgery, as opposed to primary tumors that tend to be just the tertiary centers. Finally, they hope to start building databases for degenerative deformities in the near future.
Imagine the possibilities
While Dr. Glassman admits that the ASR isn’t a perfect system, it’s far better than anything we have to date. With a combination of both breadth and granularity in the data it provides, the ASR has the potential to be one of the largest driving forces for spine surgery research in the field. Currently, we don’t have specific enough data to differentiate revisions for failed decompression or failed fusion from adjacent level revisions. Dr. Glassman believes that the ASR will rapidly tell those things apart and give surgeons granular enough data to appropriately differentiate between procedures that didn’t work and disease that has progressed to the point that a different strategy is required. That alone is exciting! I can’t wait to see how this database develops in the years to come.
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