Cervical fusion for treatment of degenerative conditions: development of appropriate use criteria.

Background Context: High quality evidence is difficult to generate, leaving substantial knowledge gaps in the treatment of spinal conditions. Appropriate use criteria (AUC) are a means of determining appropriate recommendations when high quality evidence is lacking.

Purpose: Define appropriate use criteria (AUC) of cervical fusion for treatment of degenerative conditions of the cervical spine.

Management of degenerative spondylolisthesis: development of appropriate use criteria.

Background Context: Outcomes of treatment in care of patients with spinal disorders are directly related to patient selection and treatment indications. However, for many disorders, there is absence of consensus for precise indications. With the increasing emphasis on quality and value in spine care, it is essential that treatment recommendations and decisions are optimized.

Commentary on the significance of pain catastrophizing in clinical manifestations of patients with lumbar spinal stenosis: mediation analysis with bootstrapping.

Kim HJ, Cho CH, Kang KT, Chang BS, Lee CK, Yeom JS. The significance of pain catastrophizing in clinical manifestations of patients with lumbar spinal stenosis: mediation analysis with bootstrapping. Spine J 2015;15:238-46 (in this issue).

Ghost and guest authors: you can't always trust who you read.

Clinicians and educators rely on the published medical information. They trust that original research and narrative or systematic reviews are reliable and the authorship is transparent, but this is not always the case. Disclosure of conflicts of interest by authors is required by most journals, disclosure will not detect ghost or guest authorship.

Conflict of interest and professional medical associations: the North American Spine Society experience.

Background Context: Recently the financial relationships between industry and professional medical associations have come under increased scrutiny because of the concern that industry ties may create real or perceived conflicts of interest. Professional medical associations pursue public advocacy as well as promote medical education, develop clinical practice guidelines, fund research, and regulate professional conduct. Therefore, the conflicts of interest of a professional medical association and its leadership can have more far-reaching effects on patient care than those of an individual physician.

The medical-industrial complex, professional medical associations, and continuing medical education.

Financial relationships among the biomedical industries, physicians, and professional medical associations (PMAs) can be professional, ethical, mutually beneficial, and, most importantly, can lead to improved medical care. However, such relationships, by their very nature, present conflicts of interest (COIs). One of the greatest concerns regarding COI is continuing medical education (CME), especially because currently industry funds 40-60% of CME.

Structural etiology of chronic low back pain due to motor vehicle collision.

Objective: To estimate prevalence rates of discogenic, facet, and sacroiliac joint pain, and describe clinical features of chronic low back pain patients whose symptoms were initiated by motor vehicle collisions.

Design: Retrospective chart review.

Setting: Academic spine center.

Expert opinion and controversies in musculoskeletal and sports medicine: conflict of interest.

Standaert CJ, Schofferman JA, Herring SA. Expert opinion and controversies in musculoskeletal and sports medicine: conflict of interest. Medical providers are faced with conflicts of interest (COIs) on a routine basis, but there is growing concern over the effects of COIs on medical care, medical education, research, product development, and other aspects of the health care system.

Serial therapeutic sacroiliac joint injections: a practice audit.

Objective: To determine the long-term response to serial sacroiliac joint (SIJ) corticosteroid injections. Design. Retrospective practice audit.

Effectiveness of repeated radiofrequency neurotomy for cervical facet joint pain.

Study Design: Retrospective chart review.

Objectives: To determine the success rate and duration of relief of repeat radiofrequency neurotomy (RFN) for cervical facet joint pain.

Summary Of Background Data: RFN is an effective but temporary management of cervical facet pain.

Evidence-informed management of chronic low back pain with opioid analgesics.

The management of chronic low back pain (CLBP) has proven to be very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing among available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient.

Chronic whiplash and whiplash-associated disorders: an evidence-based approach.

Whiplash is neck pain experienced as a result of a motor vehicle collision or similar trauma. Following a motor vehicle collision, 15% to 40% of patients with acute neck pain develop chronic neck pain. The cervical facet joint is the most common source of chronic neck pain after whiplash injury, followed by disk pain.

Opinions and testimony of expert witnesses and independent medical evaluators.

Objective: To clarify the guidelines and responsibilities of expert witnesses and independent medical evaluators (IMEs).

Design: Literature review and personal opinion.

Setting: There have been concerns about the objectivity of expert witnesses and IMEs due to potential financial conflicts of interest.

Web-based touch-screen computer assessment of chronic low back pain: a pilot study.

The objective of this study was to evaluate the acceptability and feasibility of a Web-based touch-screen computer questionnaire as a data collection method for patients experiencing chronic low back pain in a tertiary spine clinic. Participants completed the Oswestry Low Back Pain Disability Index, SF-36, and Beck Depression Inventory using a touch-screen computer. The time taken to complete the questionnaire was recorded electronically (M = 27.

Effectiveness of repeated radiofrequency neurotomy for lumbar facet pain.

Study Design: Retrospective chart review.

Objectives: To determine the success rate and duration of relief of repeat radiofrequency neurotomy for lumbar facet joint pain.

Summary Of Background Data: Radiofrequency neurotomy is an effective but temporary management of lumbar facet pain.