SRI Granted DOD and NIH Funds to Improve Back Pain Treatment

Treatments to combat low back pain are sorely needed (no pun intended).  It is the second most-common reason for doctor visits and is the world’s leading cause of disability.  Just in the U.S., back pain accounts for more than 100M lost workdays each year and $100 billion in treatment costs.

The Spine Research Institute (SRI) team, under the guidance of Executive Director William Marras, address the complexities of back pain from various perspectives:  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 the SRI a combined $7.8M in grants to advance its research and technology towards commercial applications.

For the DOD, the SRI is developing a wearable Spine Health Platform to improve military health and readiness. Neuro-musculoskeletal 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 technological systems attached to the head or helmet and reliance on heads-down devices.  LBP 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 disorders can degrade performance and impact mission success.

Marras hypothesizes that the primary reason for rising spine care costs, despite lack of effectiveness, is because healthcare 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.  Treatment of other major societal health problems (e.g., heart disease, diabetes) routinely use quantitative metrics to monitor disease progression and treatment effectiveness, but no similar metrics exist for spine care.  This lack of objective metrics contributes to overreliance on trial-and-error treatment approaches, which cause patients to suffer unnecessarily and inflate medical costs.

This Spine Health Platform will provide rapid, reliable and actionable metrics for the DOD, 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 5 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 the NIH initiative HEAL (Helping to End Long-Term Addiction), created to prevent and treat opioid misuse.

Marras noted that the number 1 reason people take opioids is for back pain; he and his team are determined to find a better way to relieve people’s suffering without having to rely on opioids.  To do that, SRI 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.

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.  This will allow for a better understanding of 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.

Credit: OSU College of Engineering (December 21, 2021)