Research Priorities

The North American Spine Society (NASS) is committed to funding high quality research that provides rigorously collected evidence to provide preliminary data to support future grant applications and/or to definitively answer research questions that challenge the field of spine research. In this document, the NASS Research Funding Committee provides guidance on research definitions and priorities.

Basic Research: Research may focus on projects that answer fundamental questions on the physical, chemical and functional mechanisms of processes and diseases that develop novel models for prevention and/or treatment. Basic research projects use lab (basic medicine) sciences and animal models or cell/tissue culture of animal or human origin to answer questions on the fundamental mechanisms of biological processes and diseases.

Clinical Research: Research may focus on projects with human subjects (patients or other individuals) or on material of human origin in which the research unit is a person. Clinical research focuses on the evaluation, diagnosis, treatment and outcomes of diseases or clinical conditions. Clinical research typically involves descriptive or more advanced statistics, as well as other related methodologies. Epidemiological and behavioral studies, outcomes research and health services research are also considered clinical research.

Translational Research: Translational research may focus on two types of translation. One is the process of applying discoveries generated during research in the laboratory, and in preclinical studies, to the development of trials and studies in humans. The second type of translation concerns research aimed at enhancing the adoption of best practices in the community. Cost-effectiveness studies are considered translational research.

Basic Research

  • Research on the etiology and mechanisms of spinal pain.
  • Research related to the pathobiology and/or treatment of disorders involving the spine and soft tissue (including the intervertebral disc).
    • Spinal deformity
    • Spinal cord injury (both traumatic and non-traumatic, including degenerative cervical myelopathy)
    • Oncologic conditions of the spine and spinal cord.
    • Congenital disorders of the spine.

Clinical Research

(Studies evaluating treatment outcomes should use validated outcome measures and include results specific to each of the treatment methods implemented in the study for all subgroups studied).
  • Research on the treatment and management of degenerative disc disease.
  • Research on strategies to improve clinical outcomes in the treatment of the spine.
  • Surgical
    • Examination of the efficacy of lumbar fusion, including, but not limited to:
      • Studies evaluating efficacy of fusion for degenerative disc disease in specific patient populations.
      • Prospective research to identify subgroups of patients with lumbar disc herniation with radiculopathy who may benefit from the addition of fusion to decompression as a primary procedure.
      • Studies comparing different fusion techniques in similar patient populations.
    • Antibiotic prophylaxis in spine surgery, including, studies evaluating specific antibiotic regimens, particularly for patients with significant co-morbidities.
    • Explore the role and efficacy of minimally invasive techniques in spine surgery.
  • Medical/Interventional
    • Long-term outcomes studies of specific spinal conditions that include results specific to medical/interventional treatment methods (e.g., injections, physical therapy, bracing, exercise).
    • The role and efficacy of physical therapy in the management of back pain as related to specific spinal conditions.
    • Role of complementary and alternative treatments for the spine as related to specific spinal conditions.
    • Study of the efficacy and safety of pain management strategies (pharmaceutical and non-pharmaceutical) in the treatment of spine pain.
    • Identifying patients or conditions that would better respond to early non-surgical intervention instead of interventional treatments.

Additional Funding Priorities

  • Economy of spine care
    • Examining the impact of payment models on clinical outcomes of spine care.
    • Examining cost-effectiveness/value of various strategies for spine pain and disease.
  • Comparative effectiveness
    • Studies on various treatment strategies for spine pain and disease.
  • Multidisciplinary care
    • Development of models of multidisciplinary collaboration in the care of the spine.
    • Examination of alternative delivery models that may be applied to spine and other specialty care.
  • Research around imaging of the spine
    • New technologies for diagnosis of spinal disorders.