Week Six

Research has started moving along; I now have my hands in a few different projects and need to allocate my time efficiently.  My greatest accomplishment last week was generating models based on patient MR scans for intervertebral foramen volume pre- and post-op.  The image below is an example of how I was able to segment out bone (white), foramen and central spinal canal (blue and green respectively), and implanted hardware placed during surgery (orange).  This is part of a project to develop an algorithm that will allow clinicians to quantify interventional outcomes better than previous methods.

As immersion term progresses, I am continually reminded of the namesake of our program.  Each and every day I feel completely immersed in the medical field, perusing clinical research literature, examining MR and CT films, and observing patients in both the OR and exam rooms.  My thoughts are now cluttered with black and white images of the spine.  Some with herniating intervertebral discs compressing the spinal canal, and others with large, healthy discs with high intensity nucleus pulposus and intact annulus fibrosus.  A negative effect of interacting with degenerative discs on a daily basis is that I am in constant fear of herniating my own discs, which has made me overly conscious about physical activities and mundane chores.

I have learned that an overarching theme of medicine is risk vs. reward.  A patient with a tumor has the option of a highly invasive procedure with a long recovery that will likely remove all of the malignant tissue, or they opt for a less invasive intervention with quick recovery that has shown promise but is not yet the gold standard.  A patient with spinal stenosis can undergo a minimally invasive discectomy and fusion at one level and take the risk of  revision surgery to treat adjacent segment disease, or undergo fusions at multiple levels as a precautionary measure but more severely decrease spinal mobility.  The realm of medicine rarely, if ever, lets patients have their cake and eat it too.  But this is where biomedical engineers step in, as the optimistic innovators who see dissonance as challenges and inefficiencies as opportunities.