Dr. W. Mark Erwin holds a Doctor of Chiropractic (DC) degree from CMCC, class of 1984, and a PhD obtained from the Institute of Medical Science, University of Toronto, 2004. He holds the academic rank of Assistant Professor within the Division of Orthopaedic Surgery at the University of Toronto and the Toronto Western Hospital. He is also cross-appointed to The Spine Program and is a scientist within the Krembil Research Institute (Krembil) and the Arthritis and Autoimmunity Research Centre (AARC) at the University Health Network.
Dr. Erwin currently holds the position of Scientist in Disc Biology at the University of Toronto, a position jointly funded by the Canadian Chiropractic Research Foundation, the Musculoskeltal Health and Arthritis and Neuroscience programs at the Toronto Western Hospital. He is a newly appointed associate professor at CMCC within the research division.
Dr. Erwin's principal area of interest is in development and regenerative medicine applications concerning the intervertebral disc.
Industry Expertise (5)
Areas of Expertise (6)
Canadian Chiropractic Assocation Medal of Merit (2013) (professional)
Awarded for outstanding long-term service to the CCA, the Medal of Merit is CCA’s highest honour.
Lecturer AO-Spine World Forum for Spine Research: The Intervertebral Disc (2012) (professional)
Dr. Erwin was honoured as a lecturer in 2012.
Gardiner Trust Regenerative Medicine Excellence Award (2011) (professional)
Dr. Erwin was honoured with the Gardiner Trust Regenerative Medicine Excellence Award in 2011.
University of Toronto: PhD, Cellular-Molecular Biology 2004
York University: Hons BA, Health and Physical Education/Fitness 1980
Activities and Societies: Varsity Swim team
- University of Toronto Spine Programme : Executive Committee Member
- North American Spine Society : Member
- Canadian Chiropractic Association : Member
Media Appearances (1)
Stem Cell Research Renews Hope for Spinal Injury Patients
The Vancouver Sun online
"There may be a treatment coming down the pipe for patients with spinal cord and disc injuries thanks to groundbreaking research that is underway at the University of Toronto. Dr. Mark Erwin, Canadian Chiropractic Research Foundation (CCRF) Professor in disc biology leads a team of researchers who are on a mission to unlock the regenerative properties of human intervertebral disc stem cells."
Event Appearances (2)
Degenerative disc disease: regenerative effects of stem cell therapy
Best Practices: Developing Quality Chiropractic Education, Research and Clinical Care to Promote Best Outcomes Orlando, FL
The Cellular and Molecular Biology of the Intervertebral Disc
2014 OCA Annual Conference Toronto, ON
Development of a percutaneous, minimally invasive biological therapy for treatment of degenerative disc disease (DDD) is a highly desirable objective. Such a treatment would need to provide anti-catabolic, pro-anabolic and anti-inflammatory effects on the intervertebral disc (IVD). In particular, stabilization of extracellular matrix (ECM) within the nucleus pulposus (NP) and maintenance of the healthy NP cellular phenotype would be important goals. Here we demonstrate that conditioned medium developed from the notochordal cell (NC)-rich non-chondrodystrophic (NCD) canine NP (“NCCM”) can rescue degeneration of the IVD in a preclinical rat-tail model of DDD.
15 October 2013
Study Design: This study is a combination of narrative and systematic review.
Objective: Clinicians who deal with cervical spondylotic myelopathy (CSM) should be up-to-date with the emerging knowledge related to the cascade of pathobiological secondary events that take place under chronic cervical spinal cord compression. Moreover, by performing a systematic review, we aim to (1) describe the natural history and (2) determine potential risk factors that affect the progression of CSM.
Summary of Background Data: The pathophysiology, natural history, as well as the factors associated with clinical deterioration have not been fully described in CSM.
Methods: For the first part of the study, a literature review was performed. To answer key questions 1 and 2 of the second goal, a systematic search was conducted in PubMed and the Cochrane Collaboration Library for articles published between January 1, 1956, and November 7, 2012. We included all articles that described the progression and outcomes of CSM for which no surgical intervention was given.
Results: By performing a narrative literature review, we found that the assumption that acute traumatic spinal cord injury and CSM share a similar series of cellular and molecular secondary injury events was made in the past. However, recent advances in basic research have shown that the chronic mechanical compression results in secondary injury mechanisms that have distinct characteristics regarding the nature and the temporal profile compared with those of spinal cord injury. For the purpose of the systematic review, 10 studies yielding 16 publications met inclusion criteria for key questions 2 and 3. Moderate-strength evidence related to the natural history of CSM suggests that 20% to 60% of patients will deteriorate neurologically over time without surgical intervention. Finally, there is low-strength evidence indicating that the area of circumferential compression is associated with deteriorating neurological symptoms.
Conclusion: CSM has unique pathobiological mechanisms that mainly remain unexplored. Although the natural history of CSM can be mixed, surgical intervention eliminates the chances of the neurological deterioration.
Spinal disorders and especially back and neck pain affect more people and have greater impact on work capacity and health-care costs than any other musculoskeletal condition. One of the difficulties in reducing the burden of spinal disorders is the wide and heterogeneous range of specific diseases and non-specific musculoskeletal disorders that can involve the spinal column, most of which manifest as pain. Despite, or perhaps because of its impact, spinal disorders remain one of the most controversial and difficult conditions for clinicians, patients and policymakers to manage. This paper provides a brief summary of advances in the understanding of back and neck pain over the past decade as evidenced in the current literature. This paper includes the following sections: a classification of spinal disorders; the epidemiology of spine pain in the developed and developing world; key advancements in biological and biomechanical sciences in spine pain; the current status of potential methods for the prevention of back and neck pain; rheumatological and systemic disorders that impact the spine; and evidence-based surgical and non-surgical management of spine pain. The final section of this paper looks to the future and proposes actions and strategies that may be considered by the international Bone and Joint Decade (BJD), by providers, institutions and by policymakers so that we may better address the burden of spine disorders at global and local levels.