Impact of Baseline Magnetic Resonance Imaging on Neurologic, Functional, and Safety Outcomes in Patients With Acute Traumatic Spinal Cord Injury.

Study Design: Systematic review.

Objective: To perform a systematic review to evaluate the utility of magnetic resonance imaging (MRI) in patients with acute spinal cord injury (SCI).

Methods: An electronic search of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar was conducted for literature published through May 12, 2015, to answer key questions associated with the use of MRI in patients with acute SCI.

Caregivers' perspectives on oral health problems of end-of-life cancer patients.

Purpose: The purpose of this study was to determine caregivers' perspectives on oral health problems in cancer patients at the end of life and explore factors that contribute to those perspectives.

Methods: A cross-sectional, observational clinical study design was used. We recruited dyads of lay caregivers and patients with advanced cancer who were receiving hospice or palliative care in their homes.

Cervical degenerative disease: systematic review of economic analyses.

Study Design: Systematic review.

Objective: To perform an evidence-based synthesis of the literature assessing the cost-effectiveness of surgery for patients with symptomatic cervical degenerative disc disease (DDD).

Summary Of Background Data: Cervical DDD is a common cause of clinical syndromes such as neck pain, cervical radiculopathy, and myelopathy.

Outcomes in adult scoliosis patients who undergo spinal fusion stopping at L5 compared with extension to the sacrum.

Study Design Systematic review. Study Rationale Adult scoliosis is a common disorder that is associated with significantly higher pain, functional impairment, and effect on quality of life than those without scoliosis. Surgical spinal fusion has led to quantifiable improvement in patient's quality of life.

The outcomes of manipulation or mobilization therapy compared with physical therapy or exercise for neck pain: a systematic review.

Study Design Systematic review. Study Rationale Neck pain is a prevalent condition. Spinal manipulation and mobilization procedures are becoming an accepted treatment for neck pain.

Alternative procedures for the treatment of cervical spondylotic myelopathy: arthroplasty, oblique corpectomy, skip laminectomy: evaluation of comparative effectiveness and safety.

Study Design: Systematic review.

Objective: To perform an evidence synthesis of the literature assessing the efficacy of arthroplasty, oblique corpectomy without fusion, and skip laminectomy to treat symptomatic cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Traditionally, patients with symptomatic cervical spinal cord compression due to degenerative disease have been treated with anterior or posterior approaches or both.

Cervical spondylotic myelopathy: methodological approaches to evaluate the literature and establish best evidence.

Study Design: Review of methods.

Objective: To provide a detailed description of the methods undertaken in the articles in this focus issue pertaining to cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) and to describe the process used to develop summary statements and clinical recommendations regarding factors associated with the mechanisms, diagnosis, progression, and treatment of CSM and OPLL.

Summary Of Background Data: We present methods used in conducting the systematic, evidence-based reviews and development of expert panel summary statements and clinical recommendations of the mechanisms, diagnosis, progression, and treatment of CSM and OPLL.

Frequency, timing, and predictors of neurological dysfunction in the nonmyelopathic patient with cervical spinal cord compression, canal stenosis, and/or ossification of the posterior longitudinal ligament.

Study Design: Systematic review and survey.

Objective: To perform an evidence synthesis of the literature and obtain information from the global spine care community assessing the frequency, timing, and predictors of symptom development in patients with radiographical evidence of cervical spinal cord compression, spinal canal narrowing, and/or ossification of posterior longitudinal ligament (OPLL) but no symptoms of myelopathy.

Summary Of Background Data: Evidence for a marker to predict symptom development remains sparse, and there is controversy surrounding the management of asymptomatic patients.

Risk factors for development of cervical spondylotic myelopathy: results of a systematic review.

Study Design:  Systematic review.

Study Rationale:  Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction that may be asymptomatic or may present with severe symptoms. Since CSM has an insidious manifestation, identification of risk factors associated with this condition may aid clinicians in monitoring high-risk patients and implementing appropriate management strategies.

Adjacent segment pathology following cervical motion-sparing procedures or devices compared with fusion surgery: a systematic review.

Study Design: A systematic review.

Objective: To critically review and summarize the literature comparing motion preservation devices to fusion in the cervical spine to determine whether the use of these devices decreases the development of radiographical (RASP) or clinical adjacent segment pathology (CASP) compared with fusion.

Summary Of Background Data: Historically, surgical treatment of symptomatic cervical disc disease presenting as radiculopathy and/or myelopathy with anterior cervical decompression and fusion has yielded excellent results.

Conducting research with end-of-life populations: overcoming recruitment challenges when working with clinical agencies.

Conducting end-of-life (EOL) research can present numerous challenges associated with recruitment and retention of research subjects. Such issues may result from working with a variety of clinical settings or the uniqueness of the patient population. The purposes of this article were to describe recruitment challenges in EOL research when collaborating with different types of clinical agencies and to discuss strategies that are being used to overcome these recruitment issues.

Assessment of willingness to provide diabetes education and counseling in a dental school clinic.

Diabetes mellitus is a major public health concern for the U.S. population because of its high prevalence and long-term health implications.

Model for the First NIH-funded Center of Excellence in End-of-Life Research.

Centers of excellence are widely acknowledged as a mechanism to promote scientific advances in a particular field of science, but until recently there have been no end-of-life or palliative care research centers funded by the National Institutes of Health (NIH). The purpose of this article is to describe aims, framework, and organizational structure of the first NIH-funded Center of Excellence on end-of-life research, the Center for End-of-Life Transition Research (CEoLTR), and the advances in end-of-life research that the CEoLTR will facilitate. The teams of researchers involved in the CEoLTR have grown impressively since it was funded in 2007.

Is chemical antithrombotic prophylaxis effective in elective thoracolumbar spine surgery? Results of a systematic review.

Study Design:  Systematic review Study rationale and context:  There is controversy regarding the efficacy and safety of chemical prophylaxis to prevent deep venous thrombosis (DVT) and pulmonary embolism (PE) in elective spinal procedures.Commonly performed elective spine surgeries done through a posterior approach have a very low associated risk of DVT/PE. The lack of consensus is due in part to a limited amount of quality evidence based literature dealing with this issue.

A systematic review of oral fungal infections in patients receiving cancer therapy.

Purpose: The aims of this systematic review were to determine, in patients receiving cancer therapy, the prevalence of clinical oral fungal infection and fungal colonization, to determine the impact on quality of life and cost of care, and to review current management strategies for oral fungal infections.

Methods: Thirty-nine articles that met the inclusion/exclusion criteria were independently reviewed by two calibrated reviewers, each using a standard form. Information was extracted on a number of variables, including study design, study population, sample size, interventions, blinding, outcome measures, methods, results, and conclusions for each article.

Vascular injury in elective anterior lumbosacral surgery.

Study Design: Systematic review.

Objective: To document the incidence and consequences of vascular injury in lumbosacral surgery, to identify factors contributing to this injury, and to determine whether there are any effective measures to decrease the occurrence of vascular injury.

Summary Of Background Data: Anterior lumbosacral surgery encompasses all aspects of spine surgery, including trauma, deformity, and degenerative conditions.

Blood loss in major spine surgery: are there effective measures to decrease massive hemorrhage in major spine fusion surgery?

Study Design: Systematic review.

Objective: To determine the definition and incidence of significant hemorrhage in adult spine fusion surgery, and to assess whether measures to decrease hemorrhage are effective.

Summary Of Background Data: Significant hemorrhage and associated comorbidities in spine fusion surgery have not yet been clearly identified.

Anticoagulation risk in spine surgery.

Study Design: Systematic review.

Objective: To determine the high-risk populations for thromboembolic events in spine surgery patients, the risk of anticoagulation in spine surgery patients by type of anticoagulation, and whether there is a safe perioperative window of nonanticoagulation for these high-risk patients.

Summary Of Background Data: Thromboembolic complications after major spinal surgery is a significant risk for patients.

Multiple sclerosis: an update for oral health care providers.

Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating disease of the central nervous system. The disease mostly affects young adults and is increasing in prevalence and incidence. Multiple sclerosis is characterized by periods of activity and remission which, after numerous relapses, cause permanent neurologic deficits.

Anxiety, depression, and pain: differences by primary cancer.

Goals Of Work: Disease-related cancer pain is a multidimensional phenomenon. Psychological factors that may alter pain perception in cancer patients have not been well studied. The study purpose was to explore differences in pain, anxiety, and depression by type of primary cancer.

Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy.

Background: Pain is common in head and neck cancer (HNC) patients and may be attributed to the malignancy and/or cancer treatment. Pain mechanisms and patient report of pain in HNC are expected to include both nociceptive and neuropathic components. The purpose of this study was to assess the trajectory of orofacial and other pain during and following treatment, using patient reports of neuropathic pain and nociceptive pain and pain impact.