Spine
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Narrative review. ⋯ Transparency in research methods and clear communication can avoid many of the described pitfalls in outcomes assessment, allowing researchers to advocate appropriately for improvement in patient care.
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Randomized Controlled Trial
Erector spinae muscle changes on magnetic resonance imaging following lumbar surgery through a posterior approach.
Prospective randomized study of patients undergoing lumbar arthrodesis. ⋯ Erector spinae muscle alterations mainly occur distal to posterior lumbar surgical procedures.
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Comment Review
Counterpoint: physician-industry relationships can be ethically established, and conflicts of interest can be ethically managed.
Review of the nature of conflicts of interest in physician-industry relationships, with a focus on the efforts to ethically manage physician-industry relationships. ⋯ Careful consideration of conflicts of interest in physician-industry relationships has provided an opportunity to review our goals as physicians in society, and to continue collaborative advancement of our field for the benefit of our patients.
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Comparative Study
SF-36 PCS benefit-cost ratio of lumbar fusion comparison to other surgical interventions: a thought experiment.
A retrospective review of prospectively collected data. ⋯ While the exact numbers may vary for each treatment based on the population studied and the cost estimates used, lumbar fusion cost per benefit achieved was very comparable to other well-accepted medical interventions (total hip replacement, total knee replacement, and coronary artery bypass surgery).
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Multicenter Study
Cervical transforaminal epidural steroid injections: more dangerous than we think?
Survey/case series. ⋯ This study demonstrates a significant risk of serious neurologic injury after cervical TF-ESIs. A growing body of evidence supports an embolic mechanism, whereby inadvertent intra-arterial injection of particulate corticosteroid causes a distal infarct. Embolism to the distal basilar artery region can cause midbrain, pons, cerebellum, thalamus, temporal and occipital lobe infarctions. Other potential mechanisms of infarction include vertebral artery perforation causing dissection/thrombosis and needle-induced vasospasm.