the role of fusion in the management of burst fractures of the thoracolumbar spine treated by short...
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97Journal Reports / The Spine Journal 13 (2013) 95–97
PMID: 22814567 [PubMed - in process. Available at: http://www.ncbi.
nlm.nih.gov/pubmed/22814567].
Reprinted with permission from: Jacobs WC, Arts MP, van Tulder MW,
et al. Surgical techniques for sciatica due to herniated disc, a systematic
review. Eur Spine J 2012;21(11):2232–51. Epub 2012 Jul 20. Available
at: http://link.springer.com/article/10.1007/s00586-012-2422-9.
http://dx.doi.org/10.1016/j.spinee.2013.01.010
The role of fusion in the management of burst fractures of the
thoracolumbar spine treated by short segment pedicle screw
fixation: a prospective randomised trial. Jindal N, Sankhala SS,
Bachhal V. J Bone Joint Surg Br 2012;94(8):1101–6.
The purpose of this study was to determine whether patients with a burst
fracture of the thoracolumbar spine treated by short segment pedicle screw
fixation fared better clinically and radiologically if the affected segment
was fused at the same time. A total of 50 patients were enrolled in a pro-
spective study and assigned to one of two groups. After the exclusion of
three patients, there were 23 patients in the fusion group and 24 in the
non-fusion group. Follow-up was at a mean of 23.9 months (18 to 30).
Functional outcome was evaluated using the Greenough Low Back Out-
come Score. Neurological function was graded using the American Spinal
Injury Association Impairment Scale. Radiological outcome was assessed
on the basis of the angle of kyphosis. Peri-operative blood transfusion re-
quirements and duration of surgery were significantly higher in the fusion
group (p5.029 and p!.001, respectively). There were no clinical or radio-
logical differences in outcome between the groups (all outcomes pO.05).
The results of this study suggest that adjunctive fusion is unnecessary
when managing patients with a burst fracture of the thoracolumbar spine
with short segment pedicle screw fixation.
PMID: 22844053 [PubMed - indexed for MEDLINE. Available at: http://
www.ncbi.nlm.nih.gov/pubmed/22844053].
Reproduced from: Jindal N, Sankhala SS, Bachhal V. The role of fusion in
the management of burst fractures of the thoracolumbar spine treated by
short segment pedicle screw fixation: a prospective randomised trial.
J Bone Joint Surg Br 2012;94(8):1101–6, with permission and copyright �of the British Editorial Society of Bone and Joint Surgery.
http://dx.doi.org/10.1016/j.spinee.2013.01.011
The relationship between pain and depressive symptoms after
lumbar spine surgery. Skolasky RL, Riley LH 3rd, Maggard AM,
Wegener ST. Pain 2012;153(10):2092–6. Epub 2012 Aug 3.
Although depressive symptoms are common among those living with back
pain, there is limited information on the relationship between postsurgical
pain reduction and changes in depressive symptoms. The objective of this
prospective cohort study was to examine the change in pain and depressive
symptoms and to characterize the relationship between pain and depressive
symptoms after lumbar spine surgery. We assessed 260 individuals undergo-
ing lumbar spine surgery preoperatively and postoperatively (3 and 6
months) using a pain intensity numeric rating scale and the Patient Health
Questionnaire depression scale. The relationship between change in pain
(a 2-point decrease or 30%reduction from the preoperative level) and depres-
sive symptoms was examined using standard regression methods. Preopera-
tively, the mean pain intensity was 5.2 (SD 2.4) points, and the mean
depressive symptom score was 5.03 (SD 2.44) points. At 3 months, individ-
uals who experienced a reduction in pain (63%)were nomore likely to expe-
rience a reduction in depressive symptoms (odds ratio 1.07, 95% confidence
interval [CI] 0.58 to 1.98) than individuals who experienced no change from
preoperative pain (34%).However, at 6months, individualswho experienced
a reduction in pain (63%) were nearly twice as likely to experience a reduc-
tion in depressive symptoms (odds ratio 1.93, 95% CI 1.15 to 3.25) as those
who experienced no change or an increase in pain (31%).We found thatmost
individuals experienced clinically important reductions in pain after surgery.
We concluded that thosewhosepain levelwas reduced at 6monthsweremore
likely to experience a reduction in depressive symptoms.
Copyright � 2012 International Association for the Study of Pain. Pub-
lished by Elsevier B.V. All rights reserved.
PMID: 22867701 [PubMed - in process. Available at: http://www.ncbi.
nlm.nih.gov/pubmed/22867701].
Reprinted from: Skolasky RL, Riley LH 3rd, Maggard AM, Wegener ST.
The relationship between pain and depressive symptoms after lumbar spine
surgery. Pain 2012;153(10):2092–6. Epub 2012 Aug 3. This abstract has
been reproduced with permission of the International Association for the
Study of Pain� (IASP�). The abstract may not be reproduced for any
other purpose without permission.
http://dx.doi.org/10.1016/j.spinee.2013.01.012
The sharp slowdown in growth of medical imaging: an early analysis
suggests combination of policies was the cause. Lee DW, Levy F.
Health Aff (Millwood) 2012;31(8):1876–84. Epub 2012 Jul 25.
The growth in the use of advanced imaging for Medicare beneficiaries decel-
erated in 2006 and 2007, ending a decade of growth that had exceeded 6 per-
cent annually. The slowdown raises three questions. Did the slowdown in
growth of imaging underMedicare persist and extend to the non-Medicare in-
sured?What factors caused the slowdown?Was the slowdowngood or bad for
patients?Using claims file data and interviewswith health care professionals,
we found that the growth of imaging use among both Medicare beneficiaries
and the non-Medicare insured slowed to 1–3 percent per year through 2009.
One by-product of this deceleration in imaging growth was a weaker market
for radiologists, who until recently could demand top salaries. The expansion
of prior authorization, increased cost sharing, and other policies appear to
have contributed to the slowdown. A meaningful fraction of the reduction
in use involved imaging studies previously identified as having unproven
medical value. What has occurred in the imaging field suggests incentive-
based cost control measures can be a useful complement to comparative ef-
fectiveness research when a procedure’s ultimate clinical benefit is uncertain.
PMID: 22842655 [PubMed - indexed for MEDLINE. Available at: http://
www.ncbi.nlm.nih.gov/pubmed/22842655].
Copyrighted and published by Project HOPE/Health Affairs as: Lee DW,
Levy F. The sharp slowdown in growth of medical imaging: an early anal-
ysis suggests combination of policies was the cause. Health Aff (Mill-
wood) 2012;31(8):1876–84. Epub 2012 Jul 25.
http://dx.doi.org/10.1016/j.spinee.2013.01.013