CONTINUOUS QUALITY IMPROVEMENT

THE LUMBAR SPINE FUSION

FACILITATOR: DARRELL LEE

OUR RESEACH ADVISOR:

DR. ANN MARIE FLORES

THE REST OF THE TEAM

– JIMMY GILMORE

– CORY HUSTAD

– SHANE KERLIN

– NICOLE MOTZNY

– FLAVIO SILVA

WHY DID WE CHOOSE THIS TOPIC: LUMBAR FUSION (LF)?

• LOWER BACK PAIN IS THE #1 REPORTED PHYSICAL AILMENT IN THE US

• VANDERBILT PERFORMED 173 LF IN 2007 (Dr. Davis team)

• TO CREATE A STANDARD OF CARE FOR LF AMONG SURGEONS AND PHYSICAL THERAPISTS

• AFTER ATTENDING A COURSE ON POST SURGICAL SPINE

WE REALISED THAT THE PROTOCOLS WERE NOT BASED ON RESEARCH!

• THIS IS WHAT WE FOUND IN THE RESEARCH FOR EVIDENCE BASED MEDICINE (EBM)…

• USC IS THE ONLY CURRENT AND ONGOING RESEARCH THAT WE FOUND THAT WAS TRYING

TO DEVELOP A LUMBAR FUSION PROTOCOL. THIS IS NOT AN ESTABLISHED PROTOCOL AT

THIS TIME.

OUR PURPOSE/OUR AIMS

• IN 2007-2008 WE DEVELOPED A POST-OP LUMBAR FUSION EXERCISE PROTOCOL

– THIS INCLUDED:

• COMMUNICATING WITH THE SURGEONS/STAFF TO FIND SAFE THERAPEUTIC EXERCISES

• DEVELOPING A PROTOCOL TO INCLUDE BEFORE SURGERY (PRE-OPERATION VISIT TO PT)

• WORKING WITH ACUTE CARE REHAB

• HAVING THE PATIENT COME BACK TO OUTPATIENT PT AT THE VOI

THIS YEAR WE HAVE BEEN WORKING ON IRB APPROVAL AND ADVANCING OUR RESEARCH

-WE ALL COMPLETED IRB CITI TRAINING

-WE COMPLETED THE IRB APPLICATION

-WE COMPLETED IRB APPLICATION REVISIONS

-WE HAVE CONTINUED THE DISCUSSIONS WITH THE SPINE SURGICAL TEAMS

THE SPINE PT TEAM WILL BE COLLECTING DATA RELATED TO PATIENTS WITH LF

-SF 12-OSWESTRY

AT THIS POINT IN TIME THE SURGICAL TEAMS WILL NOT BE COLLECTING THE DATA

FOR THIS STUDY

NOW WE ARE WORKING TO COMPLETE THE IRB APPROVAL SO THE DATA COLLECTION

CAN BEGIN!

THE FUTURE OF THE SPINE FOCUS TEAM….

• ANALYSIS OF THE DATA COLLECTED

• PUBLICATION

• CONTINUED COMMUNICATION WITH THE SURGICAL TEAMS

• REVISION OF PROTOCOL IF NEEDED

• COMPARATIVE STUDIES OF PT VS. NO PT AFTER SURGERY, REVISION SURGERY NUMBERS, POST-OPERATIVE COMPLICATION

ANY QUESTIONS?

• THANK YOU!