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Tue Secher Jensen graduated from the University of Southern Denmark in 2002 and has been working as a researcher since his student years. After graduation, he worked as a chiropractic intern and as a chiropractor for a couple of years alongside his work as a research assistant. In 2009, he defended his PhD thesis on the prevalence, development and clinical value of Modic changes in the general population. From 2013 to 2016, he was employed as a senior researcher and clinical associate professor at the Spine Centre of Southern Denmark and since 2013 he has also been employed as a senior researcher at the Nordic Institute of Chiropractic and Clinical Biomechanics (NIKKB). We plan on discussing topics such as: a) Getting the Bio back into Biopsychosocial; b) Distinguishing among asymptomatic vs symptomatic individuals with imaging (MRI); c) Disc herniations and sciatica – does size matter?; d) Modic changes (what are they and why do we care); e) MRI techniques and when to use imaging. 

I am excited for the opportunity to discuss chiropractic research with Drs. Peterson and Humphreys in the near future. Cynthia Peterson, RN, DC, DACBR, M.Med.Ed. has worked as a chiropractic radiologist, researcher and educator in 4 countries.  She retired from her positions as Professor and researcher, Radiology Department, Orthopaedic University hospital Balgrist and Professor, Chiropractic Medicine Programme, University of Zürich in 2017.  She is currently a Visiting Professor for the Chiropractic Department in the Faculty of Health at the University of Johannesburg, South Africa and is the Quality Assurance Consultant for the European Council on Chiropractic Education.  Barry Kim Humphreys, BSc, DC, PhD, is Professor Emeritus, Faculty of Medicine, University of Zurich. He retired in July 2017, after 9 years as the first Professor for Chiropractic Medicine in Switzerland. During this time, Professor Humphreys was responsible for the development and accreditations of the chiropractic education program, research portfolio and teaching clinic within the university, medical faculty and teaching hospital. He has been active in research including chiropractic clinical outcome studies for back and neck pain, functional MRI studies of chronic pain patients and back pain in various gravitational environments (parabolic flight).  Please comment below if you have any questions for us during the interview. I might choose some of them for our conversation.

Podcast

Dr. Ken Weber

Dr. Ken Weber and I discuss his research pursuits which involve: 1) developing imaging modalities that are more sensitive and specific to the pathology, providing more diagnostic, prognostic, and predictive information; 2) providing more quantitative information to the clinician; and 3) using these measures to better understand the nervous system and how it functions, the neurophysiology of pain, how treatments work, and why certain treatments work for some patients but not for others. Dr. Ken Weber is an Instructor in the Department of Anesthesia, Perioperative and Pain Medicine at Stanford University. He obtained his Doctor of Chiropractic from Palmer College of Chiropractic Florida in 2009 and then completed a PhD in neuroscience at Northwestern University in 2016, specializing in movement and rehabilitation science. Ken’s research intersects clinical pain research and advanced MRI techniques with an emphasis on brain, spinal cord, and musculoskeletal imaging. His research aims to better understand the neural and musculoskeletal changes underlying clinical pain conditions, the mechanisms of treatments, and predictors for recovery. Ken is currently supported by a K23 Mentored Patient-Oriented Research Career Development Award from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health. His previous funding has included the National Center for Complementary and Integrative Health, the National Institute on Drug Abuse, and the NCMIC Foundation, Inc.

I’d also like to point out that Ken was recently selected to be part of the CARL (Chiropractic Academy for Research Leadership) program

View Dr. Weber‘s research at researchgate.net.

Here are some of the papers we discuss in this episode.

1. Machine Learning for the Prediction of Cervical Spondylotic Myelopathy: A Post Hoc Pilot Study of 28 Participants.
  Hopkins BS, Weber KA 2nd, Kesavabhotla K, Paliwal M, Cantrell DR, Smith ZA.
  World Neurosurg. 2019 Jul;127:e436-e442. doi: 10.1016/j.wneu.2019.03.165. Epub 2019 Mar 25.
  PMID: 30922901 [PubMed – indexed for MEDLINE]
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2. Are Magnetic Resonance Imaging Technologies Crucial to Our Understanding of Spinal Conditions?
  Crawford RJ, Fortin M, Weber KA 2nd, Smith A, Elliott JM.
  J Orthop Sports Phys Ther. 2019 May;49(5):320-329. doi: 10.2519/jospt.2019.8793. Epub 2019 Mar 26.
  PMID: 30913967 [PubMed – in process]
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3. Lateral Corticospinal Tract Damage Correlates With Motor Output in Incomplete Spinal Cord Injury.
  Smith AC, Weber KA 2nd, O’Dell DR, Parrish TB, Wasielewski M, Elliott JM.
  Arch Phys Med Rehabil. 2018 Apr;99(4):660-666. doi: 10.1016/j.apmr.2017.10.002. Epub 2017 Oct 26.
  PMID: 29107041 [PubMed – indexed for MEDLINE] Free PMC Article
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4. Evidence for decreased Neurologic Pain Signature activation following thoracic spinal manipulation in healthy volunteers and participants with neck pain.
  Weber Ii KA, Wager TD, Mackey S, Elliott JM, Liu WC, Sparks CL.
  Neuroimage Clin. 2019;24:102042. doi: 10.1016/j.nicl.2019.102042. Epub 2019 Oct 18.
  PMID: 31670070 [PubMed – in process] Free PMC Article
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5. Deep Learning Convolutional Neural Networks for the Automatic Quantification of Muscle Fat Infiltration Following Whiplash Injury.
  Weber KA, Smith AC, Wasielewski M, Eghtesad K, Upadhyayula PA, Wintermark M, Hastie TJ, Parrish TB, Mackey S, Elliott JM.
  Sci Rep. 2019 May 28;9(1):7973. doi: 10.1038/s41598-019-44416-8.
  PMID: 31138878 [PubMed – in process] Free PMC Article
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Tue Secher Jensen

Tue Secher Jensen graduated from the University of Southern Denmark in 2002 and has been working as a researcher since his student years. After graduation, he worked as a chiropractic intern and as a chiropractor for a couple of years alongside his work as a research assistant. In 2009, he defended his PhD thesis on the prevalence, development and clinical value of Modic changes in the general population. From 2013 to 2016, he was employed as a senior researcher and clinical associate professor at the Spine Centre of Southern Denmark and since 2013 he has also been employed as a senior researcher at the Nordic Institute of Chiropractic and Clinical Biomechanics (NIKKB). Since 2017, Tue Secher Jensen has been employed at the Diagnostic Centre – Imaging Sector at the Regional Hospital in Silkeborg, Denmark, as a chiropractor doing research and reading spinal MRI. From 2018 to 2019 he was an associate professor at the Department of Clinical Medicine at Aarhus University. Tue Secher Jensen was recently (January 1st 2020) appointed, along with Lise Hestbaek (who has previously been on the podcast), as professors at the Department of Sports Science and Clinical Biomechanics at SDU.

Tue’s research has primarily focused on the clinical value of MRI findings in people with back pain. In recent years his research focus has shifted more towards clinical guidelines, knowledge translation and implementation.

See more of Tue’s research at researchgate.net.

The articles we discuss in this episode include:

1. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.
  Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG.
  AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27. Review.
  PMID: 25430861 [PubMed – indexed for MEDLINE] Free PMC Article
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2. MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis.
  Brinjikji W, Diehn FE, Jarvik JG, Carr CM, Kallmes DF, Murad MH, Luetmer PH.
  AJNR Am J Neuroradiol. 2015 Dec;36(12):2394-9. doi: 10.3174/ajnr.A4498. Epub 2015 Sep 10. Review.
  PMID: 26359154 [PubMed – indexed for MEDLINE] Free Article
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3. Magnetic resonance imaging findings as predictors of clinical outcome in patients with sciatica receiving active conservative treatment.
  Jensen TS, Albert HB, Sorensen JS, Manniche C, Leboeuf-Yde C.
  J Manipulative Physiol Ther. 2007 Feb;30(2):98-108.
  PMID: 17320730 [PubMed – indexed for MEDLINE]
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4. Natural course of disc morphology in patients with sciatica: an MRI study using a standardized qualitative classification system.
  Jensen TS, Albert HB, Soerensen JS, Manniche C, Leboeuf-Yde C.
  Spine (Phila Pa 1976). 2006 Jun 15;31(14):1605-12; discussion 1613.
  PMID: 16778696 [PubMed – indexed for MEDLINE]
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5. Modic changes, possible causes and relation to low back pain.
  Albert HB, Kjaer P, Jensen TS, Sorensen JS, Bendix T, Manniche C.
  Med Hypotheses. 2008;70(2):361-8. Epub 2007 Jul 10.
  PMID: 17624684 [PubMed – indexed for MEDLINE]
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6. Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain.
  Jensen TS, Karppinen J, Sorensen JS, Niinimäki J, Leboeuf-Yde C.
  Eur Spine J. 2008 Nov;17(11):1407-22. doi: 10.1007/s00586-008-0770-2. Epub 2008 Sep 12. Review.
  PMID: 18787845 [PubMed – indexed for MEDLINE] Free PMC Article
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7. Modic changes-Their associations with low back pain and activity limitation: A systematic literature review and meta-analysis.
  Herlin C, Kjaer P, Espeland A, Skouen JS, Leboeuf-Yde C, Karppinen J, Niinimäki J, Sørensen JS, Storheim K, Jensen TS.
  PLoS One. 2018 Aug 1;13(8):e0200677. doi: 10.1371/journal.pone.0200677. eCollection 2018.
  PMID: 30067777 [PubMed – indexed for MEDLINE] Free PMC Article
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8. Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy.
  Albert HB, Sorensen JS, Christensen BS, Manniche C.
  Eur Spine J. 2013 Apr;22(4):697-707. doi: 10.1007/s00586-013-2675-y. Epub 2013 Feb 13.
  PMID: 23404353 [PubMed – indexed for MEDLINE] Free PMC Article
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