RESEARCH NEWS
PHD’S FOR IMRCI RESEARCHERS
Two postgraduate researchers in AECC’s Institute for Musculoskeletal Research and Clinical Implementation successfully defended their PhD theses this year. Both doctoral projects centred on the Institute’s Objective Spinal Motion Imaging Assessment (QF) technology, which is an increasingly used quantitative fluoroscopy method for measuring intervertebral motion in problem spinal conditions.
Above: Fiona Mellor
Fiona Mellor (Fi) is a research radiographer who has been working in Professor Alan Breen’s team on the research and development of QF for over a decade – helping it to be successfully commercialised in the USA. Fiona’s research,
recently published in the European Spine Journal, showed for the first time that spinal motion patterns at inter- vertebral level were different in a group of chiropractic patients with chronic back pain – suggesting a mechanical subgroup. Her PhD studies, funded by the UK National Institute for Health Research used QF to explore the motion patterns between lumbar vertebrae throughout bending. She was also able to show that the X-ray dose for QF is no higher than a set of plain radiographs and publish this in the journal ‘Radiography’.
Fi presented her work in a keynote lecture to the UK Radiological Congress and also at the Royal National Orthopaedic Hospital at Stanmore. Her research has important implications for the use of imaging in chronic mechanical back pain, particularly with respect to the continued use of flexion-extension radiographs which now appears to be unjustified.
Fi continues the work in the development of QF as part of the AECC’s Special Imaging, which is receiving an increasing number of referrals from both the UK and abroad for QF and Upright MRI. (AECC is the only centre in the world where both of these are in operation.) This includes a research contract with our commercial partners for a reliability study as well as work to complete the Institute’s database of normal values against which to interpret patient findings. She has also received a new grant to lead a project to evaluate the relationships between intervertebral motion patterns and disc abnormalities – including those that can only be seen on upright MR scans – the first research to break through the technical barriers necessary to do this.
Jonny Branney is a chiropractor and qualified nurse, who obtained a fellowship grant from the European Chiropractors Union Research Fund to apply QF to the cervical spine. While also working as a clinical tutor at AECC, he measured inter-vertebral motion over a month, comparing chiropractic patients with subacute and chronic neck pain receiving spinal manipulation in the AECC clinic with healthy controls. His question was to what extent the treatment was associated with an increase in the flexion-extension range of motion at inter-vertebral levels.
Jonny’s results, published in the journal ‘Chiropractic and Manual Therapies’, have been highly accessed, receiving over 3,000 ‘hits’ in the first month of publication. They showed no significant increase in motion at any level, except for a modest dose-response if the number of manipulations given also increased. These findings are important for understanding the therapeutic effects of spinal manipulation.
Jonny’s work has opened up the QF technology to the cervical spine, helping it to receive Food and Drug Administration (FDA) clearance in the USA to be used in hospitals and adding to its commercial benefits for the AECC, which now accepts referrals for the investigation of neck conditions. It had a further important spin-off which was to determine the relationships between the cervical lordotic curve, neck pain and a course of manipulative treatment. This part of his work has been taken up as a student project and will be submitted for publication soon.
Above: Jonny Branney
Jonny’s achievement has been remarkable, completing a PhD of this calibre and importance in just over three years, whilst also supporting a young family. He has presented his work to the WFC and ECU congresses in Durban and Dublin, winning prizes at both, and at the Combined UK Spine Societies conference at the University of Warwick.
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