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Skip to content Skip to search Skip to footer Neurosurgery Open Menu Back Close Menu Search for: Search Close Search AboutAbout News Diversity, Equity &＃038; Inclusion Contact Us Giving PeoplePeople Clinical Faculty Research Faculty Affiliated Faculty Fellows Residents Advanced Practice Providers Administration Patient CarePatient Care Aneurysms/Vascular Brain Tumors Chiari Malformation / Syringomyelia Epilepsy Hydrocephalus Movement Disorders Pain Pediatrics Peripheral Nerve Spine ResearchResearch Laboratories Clinical TrialsClinical Trials Trials with Outpatient EnrollmentTrials with Outpatient Enrollment Outpatient – Pediatric Outpatient-Spine and Peripheral Nerve Outpatient – Epilepsy and Functional Outpatient-Vascular Outpatient-Oncology Trials with Inpatient EnrollmentTrials with Inpatient Enrollment Inpatient – Oncology Inpatient – Vascular Inpatient- Pediatric Inpatient-Spine and Peripheral Nerve NeurotechnologyNeurotechnology Center for Innovation in Neuroscience and Technology (CINT) NEURO360 EducationEducation Residency Program Fellowship ProgramsFellowship Programs Advanced Surgical Neuro-oncology Fellowship Endovascular Surgical Neuroradiology Fellowship Pediatric Neurosurgery Fellowship Neurosurgical Peripheral Nerve and Spine Fellowship Neurosurgical Complex Spine Fellowship Stereotactic, Functional and Epilepsy Surgery Fellowship Third-year Clerkship Diversity Sub-internship Funding Medical Student Research Opportunities Fourth-year Sub-internship Learning Environment Life Outside the Hospital Join Our Team AppointmentsAppointments Patient imaging Patient forms Open Search Outpatient-Spine and Peripheral Nerve PI: Ray Protocol ID: SC180063 Short study title: Peripheral Nerve Transfer Surgery to Improve Upper Extremity Function and Quality of Life in Tetraplegic Patients Sponsor:  Department of Defense Short description: It is estimated that greater than 250,000 Americans are living with spinal cord injury (SCI). Recovery from complete SCI is exceedingly rare, leaving most patients with permanent and significant disability. More than half of SCI occurs in the cervical spine resulting in tetraplegia. Patients with tetraplegia are dependent upon and remaining arm and/or hand function to perform functions of daily living including feeding, writing, self-transfers, and self-catheterization. Hand function, especially, is important for quality of life and recovering even partial arm and hand function after injury can result in an enormous positive impact. Peripheral nerve transfer surgeries have been increasingly utilized to treat nerve injuries, and offers a promising alternative to another well-known and widely utilized technique, tendon transfer surgery. Peripheral nerve transfer surgery may offer several advantages to tendon transfer surgery, including improving hand function in patients who may not receive any benefit after tendon transfer, maintaining biomechanics without sacrifice of function in other muscles, and not requiring prolonged immobilization. The surgery takes place in the patient’s arm.  A nerve originating from above the SCI is transferred to a nerve that originates below the injury.  This nerve is still intact, but it cannot receive the message from the brain due to the SCI. The goal of surgery is to help improve hand and/or arm function in patients with tetraplegia allowing them to be more independent in daily activities. Our group has published several case series demonstrating functional improvements provided by nerve transfers in patients with cervical SCIs. However, the optimal timing of peripheral nerve transfers, patient selection, and long-term outcomes are not well-defined even in large meta-analyses. There is a need to enroll patients and to closely follow their progress over time to better define these important factors for patients with cervical SCI with tetraplegia to help guide future clinical trials.  Participants will have a portion of their outpatient weekly therapy paid for through the Department of Defense grant. Key eligibility criteria: Diagnosis of ASIA A or B tetraplegia (SCI level C4 through C8)Any sex, age 18 through 65At least 3 months of non-operative rehab therapy with no improvementCervical SCI occurred within last 36 monthsElectromyogram and nerve conduction studies (EMG/NCS) with intact innervation to muscles below level of injuryExcludes: significant joint contractures, prior tendon transfer surgery (or planning to under tendon transfer during the study period), active system infection or infection at operative site, immunosuppressed, taking long-term steroids, active cancer, pregnancy Contact person: Linda Koester, 314-362-7368, [email protected] Enrollment period: October 2020 &＃8211; current PI: Ray Protocol ID: 202012139 Short study title: Developing a Future in Personalized Medicine in Spine Surgery (EMA) Short description: Ecological Momentary Assessment (EMA) is a brief survey used to monitor important signs of a patient’s quality of life before and after spine surgery. These factors include pain, disability, and psychosocial health. Tracking this information over time can generate data to help to improve personalized medicine for future patients. The EMA can be quickly and easily completed using a mobile phone, and participants will also be offered a wearable fitness tracker. The goal of the study is for patients to complete the survey 5 times per day for 3 weeks before the upcoming surgery and once per night, starting 5 days after surgery and continuing for 26 days. Key eligibility criteria: Any sex, age 21 through 85Has access to a smartphone and can complete surveysHas degenerative spine disease and will undergo spine surgery (fusion included)Excludes: active spine infection and/or spine cancer, patients undergoing surgery for acute spinal trauma Other information: Patients may be recruited in person while at spine clinic, over the phone, or through ZoomMonetary compensation will be provided for patients after each stage of the study A research coordinator will identify and contact potential candidates. Enrollment period: December 2020- Current PI: Ray Protocol ID: ERAS protocol 1.0 Short study title: Rapid Recovery after Minimally-Invasive Spine Surgery Short description: The Enhanced Recovery After Surgery (ERAS) program is a “fast-track” program designed to speed recovery after minimally-invasive spine (MIS) surgery. It is geared towards providing patients who are highly motivated to return to a higher quality of life an option to minimize the hospital stay and speed recovery by encouraging early mobility and initiating appropriate rehabilitation. There is an emphasis on patient education and the importance of setting realistic expectations after surgery in order to maximize recovery. Patients will be highly encouraged to undergo at least 1 session of outpatient physical therapy prior to surgery where they will be instructed on strengthening, mobility, and rehabilitation exercises to be performed after surgery. A multidisciplinary team of nurses, advanced practitioners, physicians, and therapists will work with the patient to help achieve their goal. Key eligibility criteria: Patients offered elective spine surgeries including: MIS-TLIF, ALIF, OLIF, and MIS decompressionsTransportation home and a caregiver near home for 48h after hospital dischargeExcludes: tobacco use, chronic opioid use Other information: Patients are recruited by surgeons during preoperative clinic visits A research coordinator will identify and contact potential candidates.  Enrollment period: June 2020 &＃8211; Current PI: Molina  Protocol ID: 202107045  Short study title: Activity Tracker for Patients undergoing Spine Surgery  Short description: Commercial wearable systems such as Nike+, FitBit, and Apple Watch are becoming increasingly more popular to track daily information related to walking, working, eating, and sleeping. The ease-of-use is partly due to the small size and light weight nature of the accelerometers, gyroscopes, and magnetometers used in these devices. Although more and more people are incorporating wearable systems into their daily lives, the clinical applications are largely unexplored. These devices could provide important information to improve patient care and outcomes. The goal of this study is to understand the effect of spine surgery on patients function through the analysis of continuous activity assessment measured by commercial wearable systems.   Key eligibility criteria:  Age 18 and up  Has access to an iPhone and an Apple Watch and can complete surveys. The study is currently limited to iOS® compatible devices. The patient will undergo spine surgery Excludes: Any patient in whom at least a 2-week pre-operative data collection is not possible (e.g., due to the urgency / emergency of the surgical intervention)  Other information:  Patients may be recruited in person while at spine clinic, over the phone, or through Zoom  Contact person: Miguel Ruiz Cardozo, 314-362-3649, [email protected] Enrollment period: July 30, 2021 – July 2023 PI: Ray and Molina Short study title: Augmedics XVision Surgical Navigation System Short description: In recent years, spine surgery has been increasingly been performed with the assistance of computer-navigation and robotics, which may increase accuracy of hardware placement and reduce inadvertent injury. In general, these systems have proved to be extremely safe. However, several drawbacks have been reported, including line-of-sight interruptions and attention shift. A new technology, Augmedics XVision Surgical Navigation System, is a 3D augmented-reality headset that the surgeon wears in order to integrate all intraoperative imaging into a real-time stereoscopic 3D image of the patient’s anatomy. As such, it addresses the drawback of a surgeon needing to look away from the patient in order to view intraoperative imaging. Our previous cadaveric study demonstrated a 96.7% open and 98.9% percutaneous pedicle screw placement accuracy with Augmedics, which was shown to be non-inferior to robotic-assisted computer-navigated information and superior to conventional, fluoroscopically-guided manual placement of pedicle screws. The aim of this study is to evaluate the accuracy of pedicle screw placement by the Augmedics XVision Surgical Navigation System and report on outcomes. This technology has the potential to revolutionize spine surgery and improve safety for patients undergoing spine surgery. Key eligibility criteria: Age 18 and upPatients scheduled to undergo spine surgery with pedicle screw insertion with the use of the XVS headset Patients will be enrolled at the discretion of the treating physician Enrollment period: June 2020 &＃8211; Current Clinical Trials Trials with Inpatient Enrollment Trials with Outpatient Enrollment Outpatient-Oncology Outpatient-Vascular Outpatient-Spine and Peripheral Nerve Outpatient &＃8211; Epilepsy and Functional Outpatient &＃8211; Pediatric Department of NeurosurgeryWashington University School of Medicine660 South Euclid AvenueCampus Box 8057St. Louis, MO 63110314-362-3570Contact Us Instagram Twitter YouTube Information Refer a patient Clinical faculty directory Locations Giving Careers Faculty job openings Staff job openings Patients MyChart Patient forms Patient imaging ©2024 Washington University in St. Louis