Justin Parker Neurological Institute

Background

Innovations in medical technology, surgical techniques and pharmaceuticals are driving forces in advancing the medical industry. Medical device and pharmaceutical companies have traditionally sponsored prospective clinical trials that led to the approval of new products. Unfortunately, there is now a lack of independent research organizations and clinical studies to evaluate emerging technologies and clinical outcomes in many brain and spinal disorders. Maintaining the highest standards of integrity and ethics, the Justin Parker Neurological Institute (JPNI) was in part created to conduct clinical trials and objectively assess the safety and efficacy of novel therapies for those impacted by neurological conditions.

Overview and Mission

On July 20, 2003, 22-year-old college student, Justin Parker, sustained a severe traumatic brain injury due to an unfortunate accident. Justin’s family immediately came to Colorado to be by his side. Local hospital staff, nurses and chaplain helped the Parker family cope with several days of anguish and uncertainty until his death on July 31, 2003. While they lost a son and brother, Justin’s family gained a community of friends in Northern Colorado.

Shortly after Justin’s death JPNI was founded in 2003 by Boulder Neurosurgical & Spine Associates (BNA) surgeons, Justin’s father, Dr. John Parker, and his family in memory of their son and brother. The Parker family wished to extend their appreciation to all the individuals involved in Justin’s care during his last days, while also leaving a legacy wherein Justin’s name would be synonymous with improving the lives of other individuals with neurosurgical conditions through clinical research.

JPNI is an accredited 501(c)(3) nonprofit scientific research organization primarily focusing on brain and spine conditions including traumatic brain injury, tumors, degenerative spinal disorders and pain syndromes. JPNI also provides fellowship and internship opportunities to neurosurgical and orthopedic spine surgeons and students who are pursuing careers in medicine. Continued medical education events are presented annually on the latest advancements in the treatment of cranial and spinal disorders to promote evidence-based medicine to health care providers.

Board of Directors

Alan T. Villavicencio, MD, Chairman of the Board
Boulder Neurosurgical & Spine Associates

Barbara Clausen, CPA, Treasurer
CNE CPAs and Advisors, PC

Ernie Johnson, Esq.
Retired, Pryor Johnson Carney Karr Nixon P.C.

John Parker, MD
Orthopedic Surgeon

E. Lee Nelson, MD
Boulder Neurosurgical & Spine Associates

Alexander Mason, MD
Boulder Neurosurgical & Spine Associates

Niles Utlaut, MD
Boulder Eye Care Center

Jeffrey Thramann, MD
Lanx, Inc.
ProNerve, LLC

Past, Present and Future Operations

The Justin Parker Neurological Institute was initially established as part of the Boulder Community Hospital Foundation with the primary purpose to provide support for neurosurgical research programs and services. Since its creation in 2003, a variety of research projects have been funded and conducted. These projects have included the following: clinical outcome correlation with magnesium concentrations following traumatic brain injury; evaluating the efficacy of CyberKnife radiosurgery for trigeminal neuralgia; evaluation of computerized isocentric fluoroscopy for complex spinal instrumentation; determining the safety of outpatient instrumented anterior cervical discectomy and fusion; comparing of minimally invasive pedicle fixation versus a complex antero-posterior reconstruction for lumbar disc degeneration; evaluating the safety and efficacy of recombinant human bone morphogenetic protein (rhBMP-2) for transforaminal lumbar interbody fusion; and, studying the epidemiology of back and neck pain in multisport athletes.

Some of these studies were initiated and undertaken as multicenter studies in collaboration with the following medical centers: Stanford University Department of Neurological Surgery; Department of Psychology and the Center for Neuroscience at University of Colorado; Rocky Mountain CyberKnife Center, Boulder; University of Missouri, Columbia; Department of Neurosurgery at Neuromed IRCCS in Pozili, Italy; and Besta Neurological Institute in Milan, Italy. JPNI’s goal is to continue this prolific and successful collaboration in the future.

The results of JPNI research has been published and presented at most major national and international neurosurgical meetings, including the Congress of Neurological Surgeons (CNS), American Association of Neurological Surgeons (AANS), North American Spine Society (NASS), World Spine and Spine Week annual meetings, Congress of International Stereotactic Radiosurgery Society (CISRS), Rocky Mountain Neurosurgical Society, and CyberKnife User’s meetings. JPNI-funded research has received the BrainLab Community Neurosurgery Award at the AANS/ CNS Section on Tumors and the Best Presentation Award at the 5th Annual CyberKnife Users’ meeting.

Prospective, randomized, U.S. Food and Drug Administration (FDA)-controlled studies will remain one of the most important components in the future JPNI research activities. We also seek additional individual support from medical device companies to clinically evaluate the latest and most promising medical technologies and devices. JPNI has received sponsorship from the Colorado Traumatic Brain Injury Foundation in conjunction with corporate sponsorship from CMA Microdialysis and Nova Biomedical supporting the evaluation of clinical outcome correlation with serum, CSF and brain extracellular magnesium following traumatic brain injury. We have also received three separate grants from the CyberKnife Society to support research evaluating the clinical use of CyberKnife radiosurgery for the treatment of trigeminal neuralgia, Glioblastoma Multiforme, and spinal tumors.

Current and future research projects include:

1. Correlation of Clinical Outcomes and Cervical Sagittal Alignment in Spine Surgery: A Prospective Randomized Clinical Study
2. Clinical Experience Using Interspinous Process Instrumentation System for Minimally Invasive Mini-Open Outpatient Lumbar Fusion
3. Clinical Use of Osteogenic Protein (OP-1) for Instrumented Posterolateral Fusion
4. Safety and Efficacy of Outpatient Lumbar Instrumentation and Fusion Using Various Minimally Invasive Spinal Fixation Systems
5. Clinical Experience with O-arm for Complex Spinal Instrumentation – grant submission, retrospective data analysis, and prospective study initiation
6. Pelvic Sagittal Alignment in Patients Undergoing Selective Transforaminal Lumbar Interbody Fusion for Spinal Stenosis and Scoliosis Correction
7. Implementation of Prospective Patient Clinical Outcome Database

Education

Part of JPNI’s educational mission is to disseminate information and share the latest developments in the field through the organization of periodical educational seminars for the local medical community. An annual symposium “Current Techniques in the Management of Cranial and Spinal Disorders” is sponsored and organized by JPNI every year. The main goal of this symposium is to provide an environment in which representatives from all medical professions involved in the treatment of cranial and spinal disorders become familiar with the newest procedures, technologies and devices in the field. The next meeting will take place on October 20th, 2012.

Fellowship

The Justin Parker Neurological Institute offers a fellowship in conjunction with Boulder Neurosurgical & Spine Associates. This fellowship is open to both neurosurgical and orthopedic trainees that are graduates of the U.S. accredited orthopedic or neurosurgery residency programs and eligible for an unrestricted Colorado medical license, malpractice insurance, and hospital privileges. We are unable to accept applications from physicians who are graduates of medical schools outside the U.S. and have not completed an accredited neurosurgical or orthopedic residency program in the United States. The fellowship program is of 12 months duration commencing in August of one year and ending in July of the following year.

The fellow will gain clinical knowledge and practical experience required to treat patients with spinal disorders including degenerative disc disease, fractures, spinal deformities, infections and tumors. The fellow will be instructed by a faculty of five surgeons while he/she rotates through neurosurgical and orthopaedic spine services. Boulder Neurosurgical & Spine Associates is a group of neurosurgeons with dual neurosurgical and orthopedic spine training. BNA has affiliations with The Minimally Invasive Spine Institute, Boulder Community, Longmont United and Good Samaritan hospitals located in the northwest region of Colorado. A fellow will be able to get extensive exposure to various minimally invasive techniques, interspinous process devices, artificial disc technology and kyphoplasty. There is also broad exposure to the state-of-the-art spinal instrumentation, intraoperative image guidance and imaging, and treatment modalities including stereotactic radiosurgery (CyberKnife).

Although the subspecialty training in spine surgery is mainly focused on surgical skills, it involves all aspects of conservative management, postoperative patient care, as well as clinical research. There will be ample opportunity to participate in a clinical research project(s) that will lead to publication and presentations at the national meetings during that year.

Percent of Fellowship devoted to Operative Care:	70%
Non-Operative Care:	30%
Research/Publication Obligation:	Yes

Approximate percentage of exposure to the Spine by region:

Cervical:	35%
Thoracic:	15%
Lumbar:	50%

Approximate percentage of Fellowship exposure to the Spine by diagnostic category:

Degenerative:	70%
Trauma:	15%
Deformity:	10%
Tumor:	<5%

Learning Objectives
The fellow will be able to:

• Display competence in non-operative management of spinal disorders
• Display knowledge in interpretation of advanced investigative techniques
• Display clinical competence in evaluation of spinal disorders, differential diagnosis and management
• Appreciate indications for surgery for spinal disorders
• Understand principles of multiple surgical techniques and approaches with their implications regarding complications
• Display surgical competence in complex spinal instrumentation with regards to indications
• Recognize and manage postoperative complications
• Develop communications with patient and family skills showing respect, empathy and compassion
• Understand the principles of medical ethics and gain the fundamental background for practicing medicine in an ethically responsible manner
• Develop inter-professional relationships and work effectively with physicians and other allied health professionals
• Critically apprise medical literature and research methodology, develop knowledge of current scientific literature and apply it to daily patient management
• Successfully complete a research project(s) including presentations at national meetings and publications.

To inquire or apply for the fellowship, please contact us at info@bnasurg.com

---

Fellows

Benjamin Serxner, MD received his MD from the University of California, Irvine, and recently completed his Neurosurgery residency at the University of Arizona in Tucson, Arizona. He completed a fellowship in minimally invasive and complex spine surgery with the Justin Parker Neurological Institute (JPNI) and Boulder Neurosurgical & Spine Associates (BNA) in Boulder, Colorado, in July of 2012.

The mission of JPNI is to advance scientific discoveries and innovative medical technologies into clinical practice by conducting clinical trials in order to implement best practices and disseminate to the medical community. JPNI also provides fellowship and internship opportunities to neurosurgical and orthopedic spine surgeons and students who are pursuing careers in medicine. Dr. Serxner was able to complete a top-notch fellowship and gained clinical knowledge, practical skills and research experience necessary to the management of a spine surgery practice. During his fellowship Dr. Serxner has prepared papers for publication¹ and several presentations for meetings.^2,3,4

References

1. Villavicencio AT, Babuska J, Serxner BJ, Nelson EL, Mason A, Burneikiene S. A Preliminary Report on the CO2 Laser for Lumbar Fusion: Safety, Clinical Outcomes and Technical Considerations. J Orthop Surg and Res. Submitted
2. Serxner BJ, Burneikiene S, Nelson EL, Mason A, Rajpal S, Villavicencio AT. Preliminary Clinical Outcomes in Patients Undergoing Transforaminal Lumbar Interbody Fusion with Interspinous Process Plate Fixation as an Adjunct to Pedicle Screws. 80th AANS Annual Meeting, Miami, FL, April 14 -18, 2012
3. Villavicencio AT, Serxner BJ, Babuska J, Nelson EL, Mason A, Rajpal S, Busch E, Ashton A, Burneikiene S. The Duration of Symptoms and Clinical Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion (ACDF) for Degenerative Disc Disease and Radiculopathy. NASS 27th Annual Meeting, Dallas, TX, October 24 -27, 2012
4. Serxner BJ, Burneikiene S, Nelson EL, Mason A, Rajpal S, Villavicencio AT. Transforaminal Lumbar Interbody Fusion (TLIF) with Interspinous Process Fixation Plate as an Adjunct to Unilateral Pedicle Screws: Radiological Outcomes. CNS Annual Meeting, Chicago IL, October 6 – 10, 2012

Click here for Benjamin Serxner's curriculum vitae

 

---

Internship

JPNI continues to fund an internship program for undergraduate students considering a career in medicine or clinical research. This internship offers opportunities for in-depth learning of the clinical research methodology and practice, literature searching, scientific writing, and publications.

The students that have received scholarships for their dedicated work and personal contribution to the projects over the past years:

• 2005 - Evan M. Pushchak
• 2006 - Cassandra M. Roeca
• 2008 - Jason M. Babuska
• 2009 - Kyle Healy
• 2010 - Brittany Weeks

Evan Pushchak is a Colorado native, and the first recipient of this award/scholarship. He received his medical degree from the University of Colorado and is currently undergoing residency training in emergency medicine at the Northwestern University.

“The opportunity to participate with clinical research projects in a meaningful way was an exceptional opportunity prior to attending medical school. It was also an honor to be part of the JPNI funding and mission.”

 

 

 

Click here for Evan Pushchak’s curriculum vitae

— Evan Pushchak

Cassandra Roeca graduated from the University of Colorado at Boulder. She will be matriculating as a medical student at the University of Colorado Health Sciences Center in fall 2009. She is an outdoor enthusiast and a competitive triathlete.

“As a premedical student, the scholarship from the Justin Parker Neurological Institute offered me the opportunity to do more than simply volunteer in a hospital. My internship with Boulder Neurosurgical & Spine Associates (BNA) enabled me to get involved in cutting-edge clinical research, as well as gain exposure to neurosurgical practice.

“The experience was challenging, as it entailed intensive literature analysis and topics, but it markedly strengthened my scientific reading and writing skills. This program also immersed me into the process of scientific journal writing and article submission. Several studies I was involved with were presented at meetings and have been published. Thus, I left this internship with not only an invaluable experience, but also several acclaimed accomplishments.

“I not only assisted with clinical research, but observed surgeries, and made rounds with the doctors. I will never forget the first surgery. I stood in on a pituitary tumor removal wondering if I was going to faint as they clamped the patient's head into a vice. The opportunity to be subjected to the inner workings of the operating room and medical office ultimately helped me decide to become a physician. I am very grateful for the connections I made with the surgeons, physician assistants, clinical researchers, BNA staff, and Justin Parker Neurological Institute.”

— Cassandra Roeca

Jason Babuska completed his freshmen year at the University of Michigan at Ann Arbor and transferred to the University of Colorado at Boulder the following year. He is graduating from CU-Boulder in 2009 with a major in molecular cellular developmental (MCD) biology.

“I have been involved with clinical research at Boulder Neurosurgical & Spine Associates throughout my junior and senior years at the University of Colorado at Boulder. With strong and broad interests in the neurosciences, as well as the hope of attending medical school, this has been a tremendous opportunity to gain knowledge and experience outside the classroom.

“I primarily worked on a prospective randomized clinical study that evaluated correlations between cervical sagittal alignment and clinical outcomes for patients who underwent anterior cervical fusion procedures. I am very thankful and proud to have received a stipend from the Justin Parker Neurosurgical Research Fund for my efforts in assisting with this study.

“One of my favorite aspects of the internship program was attending annual BNA symposiums, which were very memorable and rewarding experiences. Lastly, I appreciate the kindness of BNA patients who have allowed me to observe their surgeries and clinical visits.”

Click here for Jason Babuska’s curriculum vitae

— Jason Babuska

Kyle Healy graduated from the University of Colorado at Boulder in the spring of 2009 with a B.A. in Psychology. He is currently working on his M.A. in Counseling and Human Services at the University of Colorado at Colorado Springs with an anticipated graduation date of spring 2010.

“It was a real honor when I found out I had the opportunity to contribute to the research projects the Justin Parker Neurological Institute were working on. This was extremely beneficial to me as it was a very different area of research than I had previously been involved in. I was able to work on my professional writing skills while contributing to a very interesting and worthwhile undertaking. I want to thank the people I worked with for this experience and the Justin Parker Neurological Institute for the stipend I received for participating.”

Click here for Kyle Healy’s curriculum vitae

— Kyle Healy

Brittany Weeks resides in the Boston area and is a Nursing major at Quinnipiac University in Hamden, Connecticut and will be graduating in 2011.

“The opportunity to participate in clinical research brought me to JPNI and the beautiful Boulder area. This scholarship has allowed me to become immersed in a field that I have previously had little experience in. I was working on a meta-analysis review which has expanded my knowledge of neurosurgery and specifically the image technology used in the surgical field.

“The JPNI scholarship has given me the opportunity to explore the possibility of pursuing clinical research as a career path as opposed to a classic Nursing role. I am grateful to Boulder Neurological Associates and JPNI for giving me this wonderful opportunity to further explore the medical field.”

Click here for Brittany Weeks’s curriculum vitae

— Brittany Weeks

---

Donations

JPNI’s funding is derived from grants, collaborative industrial partnerships and private donations. A donation to JPNI will allow our researchers to continue their work more efficiently and identify superior methodologies to diagnose, treat and manage neurological conditions. Your support to JPNI is a commitment to a better quality of life for all individuals with neurological conditions, as well as those who may be impacted by a neurological condition in the future.

Many options for giving exist, including monetary donations, endowment funds, bequests, life insurance, charitable gift annuities and matching employer funds. You may give a gift by calling 303.938.5700. You can mail gifts to JPNI at:

Justin Parker Neurological Institute
4743 Arapahoe Ave., Ste. 202
Boulder, CO 80303