Dr. David Musante and third-year Michael Firtha published

BUIES CREEK, North Carolina – Dr. David Musante and fourth year medical student Michael Firtha are first and second authors on an abstract entitled “Clinical evaluation of an allogeneic bone matrix containing viable osteogenic cells in patients undergoing one- and two-level posterolateral lumbar arthrodesis with decompressive laminectomy” recently published in the Journal of Orthopedic Surgery and Research.

Dr. Musante provides instruction on orthopedic spinal cord surgery and pathology at CUSOM and is a spinal surgeon with Triangle Orthopedics in Durham, North Carolina and assistant professor.

“After meeting Dr. Musante in class, I reached out to him early in my MS-II year because I’m interested in orthopedics, and asked if he was working on any research projects I could help with.  It turned out that he was just starting this project, and he invited me to serve as a clinical research assistant.”

“I shadowed Dr. Musante few times per week for 3-4 months in the clinic to gain a better understanding of his charting system and how the patients present who were in our study. We evaluated the patients and reviewed their imagining studies together.  Then, I spent several weekends coming to the hospital records department to review charts of the patients in our study to find the information that was pertinent to our research.  I added the information into an electronic data capture system that was later used to analyze the data.”

“The study looked at patients with a condition called lumbar stenosis with spondylolisthesis who underwent a back surgery called a lumbar posterolateral decompression and fusion to relieve lower back pain that radiates into the legs,” explained Musante. “In this surgery, the goal is to make more space for nerves in the back that are being compressed and contributing to the patient’s pain.  This is done by removing part of the vertebrae, cleaning the space around the nerve, and fusing the unstable vertebrae to prevent movement that can be contributing to the problem.”

“To obtain fusion of the bones,” Musante continued. “Stem cells that can grow and mature into bone are added to desired vertebral segments. The stem cells are normally obtained solely from the patient’s own bone marrow (usually from the iliac crest), which requires a second procedure that has its own set of complications included infection, pain, and increased operative time.  However, our study evaluated the use of a product called Trinity Evolution which contains physiologic amounts of living, healthy osteogenic stem cells which allowed our patients to avoid the second procedure.”

“This project required Michael to learn a significant amount of medical information and develop useful skills including understanding a common spinal disorder, it’s presentation, diagnosis, treatment, outcomes and potential complications as well as how to navigate, sort through and understand a typical medical record,” continued Dr. Musante.

“I feel like I learned a lot from this research experience,” said Firtha.  “Dr. Musante is a great teacher and would spend a lot of time explaining things and answering my questions.  He taught me a lot about how to approach reading an MRI and x-ray and about many common spine conditions and their treatments.” A member of CUSOM’s inaugural class, now rising fourth years, Firtha hopes to go into orthopedic surgery and is scheduled for orthopedic audition rotations in the upcoming months.

“The project solidified my interest in pursuing an orthopedic surgery residency.  It was very exciting and motivating to get to see the improvement in quality of life that was possible in some of our patients who seemed left with very few options.  Contributing to the advancement of medicine and the orthopedic field, even in a small way, was very rewarding.”

In addition to the publication in the Journal of Orthopedic Surgery and Research, Musante mentored Firtha on a poster presentation of their research at the 2016 Womack Medical Research Symposium and were awarded 3rd place in the student category.