The Malhotra Lab, collectively, is devoted to advancing research initiatives to improve patient and population care. Initially, our sole focus was to improve the care of patients with metastatic and primary spinal cancers through improved surgical techniques and post-operative management. Starting in 2006, after recognizing that our techniques and discoveries might benefit a broader population, we additionally, and in parallel, began to study degenerative spinal disorders. Our endeavors are cyclical and have start points in the laboratory, at the veterinary school, and in clinical research. We seek to maximize the number of intersections between the phases of scientific inquiry and optimally convert every successful idea from bench to bedside to standard of care. Our teams are divided into the following core working groups (in order from bench to bedside):
There is a critical need for new innovative therapies for disc degeneration to halt or reverse its course to both alleviate painful symptoms and restore pre-degenerative structure and function. Our laboratory is successfully exploring synergistic therapeutic strategies that combine injectable hydrogel implants, sustained anti-inflammatory drug release, and stem cells that are uniquely conditioned to survive in the oxygen and nutrient-poor in vivo disc environment.
To advance clinical research for spinal cancer patients, and indeed all neurosurgical patients, we developed the EpiLog tool. The patients' EpiLog is a non-proprietary electronic health record (EHR) overlay designed to enhance care delivery through optimized data management techniques.
- Cancers of the Spinal Column and Neural Tissue
A consistent focus of the lab is to uncover differences in outcomes for patients with spinal cancers.
- Disparities in outcome
Morbidity of the diseased and declining spine is ever-present, devastating to the individual patient, and costly to society. Few outcomes data exist to guide precision therapy or enhance the value of care for the patient. We have successfully built, and tested, an IRB-approved, clinical information acquisition system (objective and patient-reported) and have captured data on more than 134,000 patients.
- Disparities in care: the Equity States Laboratory
Research has suggested that patients of diverse backgrounds, including racial and ethnic minorities, persons with disabilities, and women, may present an opportunity to improve clinical care. Given the track record of the EpiLog team to uncover disparities, in 2015 the Equity State division of the Malhotra Lab was established. The Equity States lab seeks to understand inexplicable disparities in outcome and subsequently initiate clinical trials to mitigate inappropriate differences
Our retrospective clinical research, and bench initiatives, serve as the initial proving ground for hypothetical care improvement opportunities. In the clinical trials division, members of all lab divisions, as well as external collaborators, seek to design low cost, workflow sensitive, clinical studies to test successful initiatives from the other divisions of the laboratory.