The spine journal : official journal of the North American Spine Society
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The Internet is frequently used by patients to aid in medical decision making. Multiple studies display the Internet's ineffectiveness in presenting high-quality information regarding surgical procedures and devices. With recent reports of unacceptably high complication rates and poor outcomes with the X-Stop device, it is important that online information is comprehensive and accurate. This study is the first to examine Internet information on the controversial X-Stop. ⋯ Our study demonstrates the Internet's ineffectiveness in reporting quality information on the X-Stop. Information was often incomplete and potentially misleading. Significant controversy exists within primary literature regarding the safety and efficacy of the X-Stop. Yet, publicly available Internet information largely provided misinformation and did not reflect any such controversy. This raises the concern that such information lends itself more toward patient recruitment than patient education. Medical professionals need to know how this may affect their patients' decision making.
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Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional (3D) deformity of the spine involving deviations in the frontal plane, modifications of the sagittal profile, and rotations in the transverse plane. Although Lenke classification system is based on 2D radiographs and includes sagittal thoracic and coronal lumbar modifiers, Lenke et al. suggested inclusion of axial thoracic and lumbar modifiers in the analysis. ⋯ Addition of axial plane analysis to conventional coronal and sagittal evaluations in patients with Lenke 1A curves may reveal inherent structural differences that are not apparent in single planar radiographic assessments and may necessitate a different surgical strategy.
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Fu MC, Buerba RA, Long WD III, et al. Interrater and intrarater agreements of magnetic resonance imaging findings in the lumbar spine: significant variability across degenerative conditions. Spine J 2014;14:2442-8 (in this issue).
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There are often multiple surgical treatment options for a spinal pathology. In addition, there is a lack of data that define differences in surgical treatment among surgeons in the United States. ⋯ Significant differences exist among US spine surgeons in the surgical treatment of recurrent lumbar disc herniations. It will become increasingly important to understand the underlying reasons for these differences and to define the most cost-effective surgical strategies for these common lumbar pathologies as the United States moves closer to a value-based health-care system.
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Low back pain is a frequently occurring disease caused by intervertebral disc degeneration. Mesenchymal stem cells (MSCs) are a possible treatment modality. Studies have shown MSCs can be transformed into nucleus pulposus-like cells under normoxic conditions. However, this is not a true representation of the hypoxic environment nucleus pulposus cells experience during in vivo growth and differentiation. ⋯ Hypoxic conditions lead to an increased differentiation and proliferation of nucleus pulposus-like cells. Placenta-derived mesenchymal stem cells cultured in nucleus pulposus inducing media and a hypoxic environment show enhanced expression of the nucleus pulposus-like cell markers, Sox-9, Type II collagen, aggrecan, and HIF-1α.