Spinal

Patient Population
The Toronto Western Hospital Spinal Program provides tertiary and quaternary level care to patients with medical and surgical disorders of the spine and spinal cord.

Patients come from a broad referral base including the Greater Toronto Area and across the province. Approximately 10 per cent of patients come from across Canada and from an expanding international referral base. Inpatients are cared for on the 24 bed 9B Spinal Unit which combines neurosurgical and orthopedic spinal patients. Approximately 700 complex spinal operative procedures are done annually in the Spinal Program.

A unique integrated Spinal Operating Team has been developed which combines expertise in neurosurgical and orthopedic spine surgery. A large multidisciplinary ambulatory program evaluates approximately 3,000 patients annually.

The Spinal Program has a close linkage with Princess Margaret Hospital (PMH). Spinal oncology comprises approximately 30 per cent of Program cases. The Spinal Cord Injury Unit, which is internationally renowned for cutting edge clinical care and research, cares for approximately 80 patients per year with acute spine and spinal cord injuries. In addition, the Spinal Program is closely allied with the Arthritis Program and provides expertise in the management of rheumatoid cervical spine disease and other complex spinal degenerative disorders.

Education
The Spinal Program provides clinical teaching to undergraduate medical students and residents in neurosurgery, orthopedic surgery and allied disciplines (neurology, physiatry). Neurosurgeons and orthopedic surgeons from Canada, the United States and abroad have trained at our centre. Our faculty are very active in the development of formal hands-on courses in spine surgery for residents, fellows and graduate surgeons.

Research
Clinical Research: the Spinal Program is very active in clinical research related to spinal cord injury, image guided spinal surgery, spinal oncology, the development of novel spinal instrumentation and spinal dysraphism.

Basic and Translational Research: the Spinal Program is closely linked with the Playfair Neuroscience Unit, TWH Research Institute. A collaborative Spinal Cord Injury Research Program has been developed to examine approaches to a) reduce acute nerve cell injury (neuroprotection); b) facilitate axonal regeneration; and c) to understand and modulate adaptive neural molecular and cellular responses to injury (neuromodulation).