Spine Research Institute earns DOD and NIH grants to improve back pain treatment

Low back pain is the second most common reason people visit their physicians. It’s also the world’s leading cause of disability. In the U.S. alone, back pain accounts for more than 100 million annual lost workdays and $100 billion in treatment costs.

To address the complexities of back pain, Integrated Systems Engineering Professor and Spine Research Institute (SRI) Director Bill Marras brings together a multidisciplinary team of problem-solvers throughout The Ohio State University, as well as industry partners. SRI’s team approach works because together they analyze the problem from different angles: the biomechanical complexities of the spine, the psychological and sociological factors contributing to a person’s back pain, and how technology and predictive algorithms can play a role in personalizing treatments without the use of opioids.

In recent months, both the Department of Defense (DOD) and the National Institutes of Health (NIH) have awarded a combined $7.8 million in grants to SRI to advance its research and technology towards commercial applications.

For DOD, Marras and his team are developing a wearable Spine Health Platform to improve military health and readiness. Neuromusculoskeletal injuries related to neck or low back pain (LBP) are common disabling health problems affecting both the military and general public. In military populations in particular, neck pain is one of the most commonly reported musculoskeletal disorders, likely influenced by warfighter use of technology systems that are attached to the head or helmet and reliance on heads-down devices. Low back pain is equally prevalent, and several studies have shown that warfighters with LBP have the highest risk of disability five years post-injury. Given the physical demands on warfighters, these spine disorders can lead to performance degradation and impact their ability to complete a mission successfully.

“The primary reason spine care has grown in cost but not in effectiveness, we hypothesize, is that providers lack objective and clinically actionable metrics to assess spine disorder severity and nature, track functional improvement, and determine safe return to work or duty,” explained Marras.

This lack of objective metrics has contributed to the overreliance on trial-and-error treatment approaches that produce unnecessary patient suffering and highly inflated medical costs. Treatment of other major health problems facing society – such as heart disease and diabetes – routinely employ quantitative metrics to monitor disease progression and treatment effectiveness, yet no similar metrics exist for spine disorders.

SRI’s Spine Health Platform will provide rapid, reliable and actionable metrics to inform clinical decision-making and enhance warfighter health, operational effectiveness and mission readiness. The product under development is an integrated platform that provides a non-invasive, cost-effective and holistic evaluation of spine health for both neck and low back in five to 10 minutes. This innovative technology builds on decades of prior research funded with DOD, NIH and Ohio Bureau of Workers Compensation grants to provide a suite of functional spine motion biomarkers to objectively track clinical function, monitor treatment effectiveness and identify at-risk personnel.

As part of the recently awarded $3.38 million DOD project, SRI brings together a core multidisciplinary team from Ohio State, Switchbox, Uniformed Services University, GBQ Partners, Priority Designs, Prophetech and military stakeholders to further develop their platform for commercial use in both military and civilian environments. The assembled project team has a history of collaboration through DoD STTR/SBIR and NIH efforts.

When it comes to clinical treatment, Marras and his team are developing technology to help physicians pinpoint and treat back pain properly through the Spine Phenome Project. It is funded by BACPAC (Back Pain Consortium Research Program), part of an NIH initiative called HEAL (Helping to End Long-Term Addiction) to prevent and treat opioid misuse.

“The No. 1 reason people take opioids is for back pain, and we’re determined to find a better way to relieve people’s suffering without having to rely on opioids,” Marras said.

To do that, Marras and his team will use a $3.86 million NIH BACPAC grant to further develop and validate the digital health platform that provides data-driven information to help physicians evaluate and treat patients accurately. The system includes wearable sensors that analyze a person’s spine as they move. It identifies potential pain sources and mobility problems by creating a computer model, accurately showing physicians and surgeons why someone might be experiencing pain.

“We’re marrying imaging data with motion data and bringing the MRI to life,” Marras explained.

As part of the NIH collaborative effort, the platform technology will be deployed across 11 U.S. academic medical centers to collect quantitative biopsychosocial measures to better understand the various manifestations of back pain across care systems, inform clinical decision-making on appropriate treatments to patient subgroups or phenotypes, and improve outcomes.

Collectively, the Spine Health Platform will serve as a decision-support tool that leverages a unique statistical database of diverse information from back pain sufferers and uses machine learning algorithms to phenotype patients, enhance clinical decisions and personalize treatments to improve outcomes.

Both projects will help SRI and its project partners submit the platform technology for U.S. Food and Drug Administration regulatory submission as a tool for clinical use.