Spine

The St. Michaels Hospital Spine Program is a combined orthopedic and neurosurgical program. The main areas of research include spinal cord injuries, deformity, education, minimally invasive spine surgery and engineering applications in spine surgery, as well as clinical outcomes in all aspects of surgical spine care.


At St. Michael’s, Dr. Ahn says, spine specialists in neurosurgery and orthopedics work well together. “It’s not the building,” he says. “It’s the network of individuals who make all the difference.” Given the talent and expertise shown by the team, it’s no wonder St. Michael’s is a leader in this area.

Featured Study

Rick Hansen Spinal Cord Injury Registry

Using standardized research protocols and data collection forms, we track the experiences and outcomes of people with traumatic spinal cord injuries during their journey from acute care to rehabilitation to community reintegration. Details about participants’ spinal cord injuries including extent of injury and level of paralysis, recovery and success of various treatments are among the data recorded. Across Canada, we are collecting comprehensive spinal cord injury data for the purpose of improving care and clinical outcomes. The registry promotes, encourages and supports the pursuit of excellence in spinal cord injury health care management.


Other featured studies with spine research include:

  • Engineering applications in spine surgery
  • Development of the Smart Laser Scalpel system using a novel Picosecond Infrared Laser and mass spectrometry
  • Cold laser ablation with real-time tissue identification
  • Design and testing a less invasive spinal-fusion device
  • Ultrasound-guided pedicle screw insertion
  • Computer modeling of spinal fusion surgery
  • Development of less invasive image-guided spinal surgical procedures
  • Ultrasound-guided high intensity focused ultrasound treatment for tumours

Featured Publications

  • Spinal dural arteriovenous fistula associated with L-4 isthmic spondylolisthesis. Nishimura Y, Natsume A, Ginsberg HJ. J Neurosurg Spine. 2014 Apr 18. [Epub ahead of print]
  • Progressively Unstable C2 Spondylolysis Requiring Spinal Fusion: Case Report. Nishimura Y, Ellis MJ, Anderson J, Hara M, Natsume A, Ginsberg HJ. Neurol Med Chir (Tokyo). 2014 Feb 28. [Epub ahead of print]
  • Spinal intradural cystic venous angioma originating from a nerve root in the cauda equina. Nishimura Y, Hara M, Natsume A, Nakajima Y, Fukuyama R, Wakabayashi T, Ginsberg HJ. J Neurosurg Spine. 2013 Dec;19(6):716-20. doi: 10.3171/2013.8.SPINE121012. Epub 2013 Oct 4.
  • A novel device to simplify intraoperative radiographic visualization of the cervical spine by producing transient caudal shoulder displacement: a 2-center case series of 80 patients. Witiw CD, Citow JS, Ginsberg HJ, Spears J, Perrin RG, Cusimano MD, Macdonald RL. J Neurosurg Spine. 2013 Dec;19(6):697-700. doi: 10.3171/2013.9.SPINE11998. Epub 2013 Oct 4.
  • 5 Level fusion with screws perfectly in place Guided pedicle screw insertion: techniques and training. Manbachi A, Cobbold RS, Ginsberg HJ. Spine J. 2014 Jan;14(1):165-79. doi: 10.1016/j.spinee.2013.03.029. Epub 2013 Apr 25.
  • Evaluating the ability of posterior elements to support new instrumentation for spinal fusion. Singh DA, Ginsberg HJ, Whyne CM. Proc Inst Mech Eng H. 2011 Nov;225(11):1084-91.
  • Skull fracture secondary to application of a Mayfield skull clamp in an adult patient: case report and review of the literature. Matouk CC, Ellis MJ, Kalia SK, Ginsberg HJ. Clin Neurol Neurosurg. 2012 Jul;114(6):776-8. doi: 10.1016/j.clineuro.2011.12.036. Epub 2012 Jan 18. No abstract available.
  • Surgical treatment of spontaneous intracranial hypotension secondary to degenerative cervical spine pathology: a case report and literature review. Witiw CD, Fallah A, Muller PJ, Ginsberg HJ. Eur Spine J. 2012 Jun;21 Suppl 4:S422-7. doi: 10.1007/s00586-011-1979-z. Epub 2011 Aug 27. Review.
  • On ultrasound imaging for guided screw insertion in spinal fusion surgery. Aly AH, Ginsberg HJ, Cobbold RS. Ultrasound Med Biol. 2011 Apr;37(4):651-64. doi: 10.1016/j.ultrasmedbio.2011.01.011. Epub 2011 Mar 3.
  • Exploring the role of 3-dimensional simulation in surgical training: feedback from a pilot study. Podolsky DJ, Martin AR, Whyne CM, Massicotte EM, Hardisty MR, Ginsberg HJ. J Spinal Disord Tech. 2010 Dec;23(8):e70-4. doi: 10.1097/BSD.0b013e3181d345cb.
  • CT-based patient-specific simulation software for pedicle screw insertion. Klein S, Whyne CM, Rush R, Ginsberg HJ. J Spinal Disord Tech. 2009 Oct;22(7):502-6. doi: 10.1097/BSD.0b013e31819877fd.
  • Beyond the operating room: a simulator for sacroiliac screw insertion. Rush R, Ginsberg HJ, Jenkinson R, Whyne CM. Surg Innov. 2008 Dec;15(4):321-3. doi: 10.1177/1553350608327170.
  • Development of a method for ultrasound-guided placement of pedicle screws. Mujagić M, Ginsberg HJ, Cobbold RS. IEEE Trans Ultrason Ferroelectr Freq Control. 2008;55(6):1267-76. doi: 10.1109/TUFFC.2008.789.
  • L2 Burst Fracture pre and post operative Spinal epidural cavernous hemangioma in an HIV-positive patient. Akiyama M, Ginsberg HJ, Munoz D. Spine J. 2009 Feb;9(2):e6-8. doi: 10.1016/j.spinee.2007.10.041. Epub 2008 Feb 20.
  • Minimizing errors in acute traumatic spinal cord injury trials by acknowledging the heterogeneity of spinal cord anatomy and injury severity: An observational Canadian cohort analysis. Dvorak MF, Noonan V, Fallah N, Fisher CG, Rivers CS, Ahn H, Tsai EC, Linassi G, Christie S, Attabib N, Hurlbert RJ, Fourney DR, Johnson MG, Fehlings M, Drew B, Bailey C, Paquet J, Parent S, Townson A, Ho C, Craven BC, Gagnon D, Tsui D, Fox R, Mac-Thiong JM, Kwon BK. J Neurotrauma. 2014 May 8. [Epub ahead of print]
  • Improving access to emergent spinal care through knowledge translation: an ethnographic study. Webster F, Fehlings MG, Rice K, Malempati H, Fawaz K, Nicholls F, Baldeo N, Reeves S, Singh A, Ahn H, Ginsberg H, Yee AJ. BMC Health Serv Res. 2014 Apr 14;14:169. doi: 10.1186/1472-6963-14-169.
  • Meeting the privacy requirements for the development of a multi-centre patient registry in Canada: the Rick Hansen Spinal Cord Injury Registry. Noonan VK, Thorogood NP, Joshi PB, Fehlings MG, Craven BC, Linassi G, Fourney DR, Kwon BK, Bailey CS, Tsai EC, Drew BM, Ahn H, Tsui D, Dvorak MF. Healthc Policy. 2013 May;8(4):87-99.
  • Preoperative carbohydrate loading in patients undergoing coronary artery bypass or spinal surgery. Tran S, Wolever TM, Errett LE, Ahn H, Mazer CD, Keith M. Anesth Analg. 2013 Aug;117(2):305-13. doi: 10.1213/ANE.0b013e318295e8d1. Epub 2013 Jun 11.
  • Central coordination as an alternative for local coordination in a multicenter randomized controlled trial: the FAITH trial experience. Zielinski SM, Viveiros H, Heetveld MJ, Swiontkowski MF, Bhandari M, Patka P, Van Lieshout EM; FAITH trial investigators. Trials. 2012 Jan 8;13:5. doi: 10.1186/1745-6215-13-5.
  • Empirically derived maximal acceptable wait time for surgery to treat adolescent idiopathic scoliosis. Ahn H, Kreder H, Mahomed N, Beaton D, Wright JG. CMAJ. 2011 Jun 14;183(9):E565-70. doi: 10.1503/cmaj.101511. Epub 2011 May 2.
  • Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. Ahn H, Singh J, Nathens A, MacDonald RD, Travers A, Tallon J, Fehlings MG, Yee A. J Neurotrauma. 2011 Aug;28(8):1341-61. doi: 10.1089/neu.2009.1168. Epub 2010 Jun 16. Review.
  • An evidence-based approach to the adoption of new technology. Ahn H, Bhandari M, Schemitsch EH. J Bone Joint Surg Am. 2009 May;91 Suppl 3:95-8. doi: 10.2106/JBJS.H.01593.
  • The use of hospital registries in orthopaedic surgery. Ahn H, Court-Brown CM, McQueen MM, Schemitsch EH. J Bone Joint Surg Am. 2009 May;91 Suppl 3:68-72. doi: 10.2106/JBJS.H.01592.
  • Spine x-ray Prevention, identification, and treatment of perioperative spinal cord injury. Ahn H, Fehlings MG. Neurosurg Focus. 2008;25(5):E15. doi: 10.3171/FOC.2008.25.11.E15. Review.
  • Tranexamic Acid reduces perioperative blood loss in adult patients having spinal fusion surgery. Wong J, El Beheiry H, Rampersaud YR, Lewis S, Ahn H, De Silva Y, Abrishami A, Baig N, McBroom RJ, Chung F. Anesth Analg. 2008 Nov;107(5):1479-86. doi: 10.1213/ane.0b013e3181831e44.
  • Biomechanical analysis of plate osteosynthesis systems for proximal humerus fractures. Lever JP, Aksenov SA, Zdero R, Ahn H, McKee MD, Schemitsch EH. J Orthop Trauma. 2008 Jan;22(1):23-9. doi: 10.1097/BOT.0b013e31815c89ce.
  • The impact of surgical wait time on patient-based outcomes in posterior lumbar spinal surgery. Braybrooke J, Ahn H, Gallant A, Ford M, Bronstein Y, Finkelstein J, Yee A. Eur Spine J. 2007 Nov;16(11):1832-9. Epub 2007 Aug 14.
  • Repeated meningitis as a delayed complication of scoliosis surgery. da Costa LB, Ahn H, Montanera W, Ginsberg H.
  • The effect of pre-vertebroplasty tumor ablation using laser-induced thermotherapy on biomechanical stability and cement fill in the metastatic spine. Ahn H, Mousavi P, Chin L, Roth S, Finkelstein J, Vitken A, Whyne C. Eur Spine J. 2007 Aug;16(8):1171-8. Epub 2007 Apr 20.
  • Stability of the metastatic spine pre and post vertebroplasty. Ahn H, Mousavi P, Roth S, Reidy D, Finkelstein J, Whyne C. J Spinal Disord Tech. 2006 May;19(3):178-82.
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