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