clinical update may 2006 · spine surgeons suny upstate’s department of orthopedic surgery...

S y r a c u s e , N e w Y o r k

A1MD Direct: 800-544-1605: University Hospital’s Physician-To-Physician Service

THE ACADEMIC DIFFERENCE

SUNY UPSTATE MEDICAL UNIVERSITY& University Hospital

Clinical Update May 2006

Spine Surgeons SUNY Upstate’s Department of Orthopedic Surgery welcomes two fellowship-trained spine surgeons, both with impressive backgrounds in clinical and laboratory research, as well as expertise in a full range of spine procedures.

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Stroke RecoveryA new clinical trial examines the impact of electrical stimulation on stroke recovery.

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The Diagnostic Power of Volume CTThe causes of chest pain can be diagnosed more quickly, thanks to revolutionary new equipment available at University Hospital’sEmergency Department. Volume-computed tomography (VCT) provides highly powerful CAT scans, diagnostic tools that are especially valuable at the region’s only level-one trauma center.

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$1 Million for the Children’s HospitalA $1 million gift from Bristol-Myers Squibb ensures a “park-like” refugeat the Golisano Children’s Hospital at University Hospital.

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SUNY UPSTATE MEDICAL UNIVERSITY& University Hospital S y r a c u s e , N e w Y o r k

SUNY Upstate Medical University’s Institute for SpineCare, under the longtime leadership of Hansen A. YuanMD and Bruce E. Fredrickson MD, has added two

fellowship-trained spine surgeons: Amir H. Fayyazi MD, whojoined the faculty in 2004, and Mike H. Sun MD, whojoined the faculty in 2006. The addition of these two spinesurgeons builds on the strength of the nationally rankedDepartment of Orthopedic Surgery at University Hospitaland SUNY Upstate Medical University.

Treatment Options

Drs. Fayyazi and Sun offer a full range of procedures for thetreatment of adult and pediatric spinal pathologies includingtrauma and deformity, and degenerative diseases such asstenosis and disc herniation. Fayyazi has a special interest inminimally invasive procedures of the spine and treatment ofspinal deformities. Sun’s special interest focuses on thetreatment of complex cervical diseases.

“The services available at University Hospital allow us tosafely treat complex pathologies such as fractures, spinal

deformity and tumors,” says Dr. Fayyazi. One of theseadvantages is the availability of the neuromonitoringtechnology provided by SUNY Upstate’s Department of Neurosurgery. This state-of-the-art technique allows real-time monitoring of the spinal cord during spinal procedures, significantly decreasing the risk of spinal cord injury during the surgery.

Research Interests

In addition to their clinical practices, both surgeons areinvolved in laboratory research at the Institute for HumanPerformance and clinical research at SUNY Upstate MedicalUniversity. “The Institute for Spine Care has always been onthe forefront of emerging technologies for the treatment ofspinal diseases,” notes Sun. “One such area is the applicationof motion-preserving technology to the treatment of spinalpathologies. Another example is the lumbar-disc replacementwhich has been FDA-approved. Other motion-preservingprocedures being studied include cervical-disc replacementand dynamic lumbar stabilization.

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The Institute for Spine Careleads in the treatment

of spinal pathology.


Fellowship-trained spine surgeons Amir Fayyazi MD (left) and Mike Sun MD.

A3THE ACADEMIC DIFFERENCEMD Direct: 800-544-1605: University Hospital’s Physician-To-Physician Service

Amir H. Fayyazi, MD� Fellowship: Rush-Presbyterian,

St. Luke Medical Center, Chicago

� Residency: Milton S. HersheyMedical Center

� MD: Washington UniversitySchool of Medicine

� BS: Johns Hopkins UniversityDepartment of Engineering

� Selected Publications: The SpineJournal, Journal of Spinal Disorderand Technique, Journal of Boneand Joint Surgery, AmericanJournal of Orthopaedics, CurrentOpinion in Orthopaedics, Foot &Ankle International, AmericanJournal of Physiology, Circulation

Mike H. Sun, MD� Traveling Fellowship: 2005

Cervical Spine Research Society

� Fellowship: Case Western Reserve University

� Residency: University of Chicago

� MD: Baylor College of Medicine

� BS: Yale University

� Selected Publications: CurrentGene Therapy, Gene Therapy, the Journal of CellularBiochemistry

Spine Procedures

� Cervical, Thoracic andLumbar Decompression,Fusion andInstrumentation

� Minimally InvasiveProcedures (LumbarDiscectomy, LumbarFusion, CervicalLaminoforaminotomy and Kyphoplasty)

� Lumbar Total Disc Replacement

� Cervical Total Disc Replacement(Research Study)

� Posterior DynamicStabilization (Research Study)



The impact of electrical stimulationduring stroke rehabilitation is thefocus of a new clinical trial at

SUNY Upstate Medical University:“Safety and Effectiveness of CorticalStimulation in the Treatment of UpperExtremity Hemiparesis,” also known asthe “Everest” study.

Patients are being recruited for the trial,according to Charles J. Hodge MD,chair of the Department of Neuro-surgery and SUNY Upstate’s principalinvestigator for the multisite study.

The study will measure the safety andeffectiveness of electrical stimulationdelivered by an implantable pulsegenerator (IPG) to the cerebral cortex during rehabilitation activities,Dr. Hodge explains.

The cerebral cortex is believed to be animportant site for neuroplasticity, aprocess of reorganization in which newareas of the brain assume the functionof stroke-damaged areas. Findings fromprevious laboratory and clinical studiessuggest that cortical stimulation therapyis safe and appears to increase motorfunction in stroke survivors, more sothan rehabilitation alone.

Common After-Effect

Weakness on one side of the body is acommon consequence of stroke andoften prevents stroke survivors fromperforming basic daily activities.Rehabilitative therapy is the standardtreatment for this motor deficit, but

some patients achieve little, if any,improvement of motor function.

“The study will provide furtherevidence needed to determine if thisproposed method of treatment –electrical cortical stimulation givenconcurrently with rehabilitativeactivities – is safe and effective forstroke survivors,” Dr. Hodge explains.“If successful, as evidenced by improvedmotor recovery and associated activitiesof daily living in stroke patients, itwould likely have important health,quality-of-life and economic benefitsfor many people.”

The time commitment for the studyis approximately eight months,consisting of up to two weeks forbaseline activity, such as general health assessment and motor functiontesting; six weeks for rehabilitativetreatment with or without the use ofthe implantable system; and six monthsfor follow-up.

Up to 330 patients will be enrolled inall of the investigational sites to obtaina total of up to 174 volunteers appro-priate for the study. Up to 110 of thesevolunteers will be part of an investiga-tional group which receives theimplanted stimulation system and undergoes targeted electricalstimulation concurrent with rehabilitation therapy.

Up to 64 patients will be randomizedto the control group – but withoutconcurrent electrical stimulation.

Stroke Recovery Trial Focuses on Cortical Stimulation

Charles J. Hodge MD, chair of theDepartment of Neurosurgery,

SUNY Upstate Medical University


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Stroke Recovery Trial Patient Criteria� Among other criteria, study volunteers must be 21 years of age or older and have

experienced an ischemic (transient ischemic) stroke at least four months ago, causingmuscle weakness in the shoulder, arm, wrist and hand on one side of the body.Candidates must also be medically and neurologically stable, able to undergo magneticresonance imaging (MRI) and an implant procedure; and sign an informed consent.

� The participants will be assessed by standardized and validated tests of function,disability, and quality of life by raters who will not be apprised of to which group each volunteer is assigned. Study participants will conceal evidence of the device implant and refrain from discussing study procedures with the raters.

� The implanted device system is used only during rehabilitation activities and will beremoved approximately eight weeks following the completion of rehabilitation therapy.None of the implantable components directly touches the brain. The FDA approved allcomponents for use in this study.

� The system, designed to minimize risk to the volunteers, includes features to ensure negligible electrical risk to the patient and the ability to rapidly terminate therapy ifneeded. Trained study personnel initiate and monitor cortical stimulation via a handhelddevice. The device delivers personalized stimulation appropriate to the functional abilityof each participant. A nurse or physician will be available for the duration of the rehabilitation session.

� Joining Dr. Hodge on the study team from SUNY Upstate are Charles Bradshaw PhD,clinical associate professor of neurology; Margaret Turk MD, professor of physical medicine and rehabilitation and pediatrics; and Michael Vertino MD, assistant professorof neurology. Study coordinator is Lorraine Padden CNR, ANP.

To learn more about the study, call 1-888-546-9779.

“Everest”Study



Revolutionary VCT forHeart, Stroke & TraumaUniversity Hospital is the

only hospital in the regionto acquire a LightSpeed®

VCT, the most advancedcomputed tomography imagingsystem available from GEHealthcare. The VCT (VolumeComputed Tomography), housed in University Hospital’sEmergency Department, produces64 images in one 0.35-secondrotation, providing doctors withnew diagnostic power, includingCT angiography and rapid testsfor help in diagnosing patientswith chest pain.

The VCT is maintained andoperated by the hospital’sDepartment of Radiology.

According to David Feiglin MD,professor and chair of theDepartment of Radiology,“University Hospital is the onlyhospital in the region to have thisVCT capability in its EmergencyDepartment, giving doctors andpatients immediate access to ahighly powerful and accurateCAT scan when needed. This is particularly important sinceUniversity Hospital is designatedas the level 1 trauma center for our region.”

Dr. Feiglin says the VCTrepresents a new era in imaging,offering an innovative way to

diagnose cardiovascular disease.“We are currently using theVCT for more traumatic-relatedinjuries,” he explains. “Within afew months, we plan to use thesystem to perform new andenhanced procedures, such asCT coronary angiography, tobetter evaluate patients sufferingfrom chest pain.”

In this capacity, the LightSpeedVCT allows doctors to captureimages of the entire heart andcoronary arteries in just fiveheartbeats, providing clearerimages of cardiovascularanatomy and a shorter breathhold for sick and elderlypatients. In a single fast scan, italso gives physicians the abilityto rule out aortic dissection,pulmonary embolism andcoronary artery disease – three of the primary causes of mortality in patients withchest pain.

The VCT also has the speed and resolution necessary forrapid imaging of blood vessels in the brain. “This enablesphysicians to quickly diagnose a stroke and to determine theextent of damage, making acomplex procedure easier andmore routine for the physician,” says Dr. Feiglin.

“The most advancedcomputed tomo-graphy imaging system available.”

CT angiogram of the aorta and pulmonary vasculature. From the Visualization Lab,

SUNY Upstate Medical University

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The focal point of the GolisanoChildren’s Hospital – the 11th-floor treehouse lobby –

will be named for Bristol-Myers Squibbin recognition of its $1 milliondonation to the Golisano Children’sHospital at University Hospital.

Bristol-Myers Squibb is a leadinginternational pharmaceutical companywith laboratories and manufacturingfacilities in Syracuse. The gift is thelargest corporate philanthropic contri-bution in the history of SUNY Upstate.

“The Golisano Children’s Hospital willbe an exciting place for physicians towork, conduct research and serve ourcommunity,” commented Ken Dauria,senior director of Syracuse Operationsfor Bristol-Myers Squibb. He also notedthat the Children’s Hospital could helpattract talented individuals from acrossthe country to work at Bristol andother companies in Central New York.

Gateway

Parents and children will enter thetreehouse lobby as they exit the elevatoron the 11th floor of the UniversityHospital expansion. The lobby willinclude a café, lounges, play areas, andample seating areas.

According to Thomas Welch MD, chairof SUNY Upstate’s Department ofPediatrics, “This will be a place wherefamilies and children can go for abreak. We hope to create a park-like

atmosphere just steps away from thehospital bed. This gift from Bristol-Myers Squibb ensures that we have the best space possible.”

The Bristol-Myers Squibb gift bringsthe total of the community-wide givingcampaign to $21.5 million. Thenaming gift for the children’s hospitalwas announced in November 2005when B. Thomas Golisano, founderand chair of Paychex Inc., personallypledged $6 million.

In the last two decades, Bristol-MyersSquibb has contributed nearly$900,000 to SUNY Upstate projectsand programs, including cancerresearch, the Joslin Diabetes Center, the thoracic surgery program and theCNY Children’s Miracle Network.

The Golisano Children’s Hospital will comprise the top two floors ofUniversity Hospital’s vertical expansion,which will include new patient carefloors for cardiovascular, neurosurgeryand oncology services.


Architectural rendering of the “treehouse lobby” of Golisano Children’s Hospital atUniversity Hospital. Karlesberger Architects of Columbus, Ohio

Bristol-Myers Squibb Pledges $1 million to Children’s Hospital

clinical update may 2006 · spine surgeons suny upstate’s department of orthopedic surgery...

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