Using research to answer clinical questions to treat spine conditions

Dr. Nathan Evaniew, MD, PhD, FRCSC, believes impactful research starts with asking the right question.

Evaniew began his career in medicine as an orthopaedic spine surgeon with a passion for helping people. “Like many before me, I went into medicine to help people, and I quickly realized that surgical care can have a profound impact on patients' quality of life,” explains Evaniew, who is now an orthopaedic spine surgeon and clinical assistant professor at the Cumming School of Medicine. In his clinical practice Evaniew treats patients living with various spine disorders such as degenerative, traumatic, oncological, and developmental conditions.

Early in his medical training, Evaniew became inspired by the impact of research. “During training to be an orthopaedic surgeon, I was surrounded by wonderful academic mentors who were performing world-class research. I realized that as surgeons we can help individuals, which is itself important work, but as researchers, we can also potentially help populations,” he explains.

Evaniew completed his medical training at the Cumming School of Medicine and then completed an orthopaedic surgery residency and obtained a PhD in Clinical Epidemiology and Biostatistics at McMaster University. Today, he uses his health research background to apply an evidence-based medicine approach that combines research, clinical expertise, and patient values to spine surgery. “My goal is to help people by asking important questions and answering them reliably,” he explains. Through his research, he studies the effectiveness of spine surgery procedures and aspects of care to determine the best treatment plans.

Evaniew is involved in collaborative multi-centre studies through the University of Calgary Spine Program, the Canadian Spine Outcomes and Research Network, the Praxis Spinal Cord Institute, and the international group AOSpine. These studies use data from large patient cohorts to answer clinical questions relating to techniques of surgery, timing of spine surgery, and methods for pre and post-surgery management. Among his current projects, he is working with colleagues on studies evaluating surgery for people living with cervical myelopathy, a disabling condition in which age-related degenerative changes compress the spinal cord and cause progressive impairments of strength, sensation, balance, and coordination. The studies aim to optimize patient outcomes by better understanding how to balance the various risks and benefits of having an operation.

“My dual roles as a clinician and a researcher are energizing because clinical practice leads to research questions, and research provides the answers to help us improve patient care,” explains Evaniew.