Spine Surgeons Give New Perspective to Controversial Procedures

Three controversial spine treatments were the subject of new studies and presentations at the North American Spine Society annual meeting in Chicago, according to a NASS news release.

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One study focused on provocative discography, an invasive diagnostic procedure involving disc puncture and injection. The study originally enrolled 150 people who underwent 10-year surveillance, 57 of which underwent the discography procedure. The discography group had more adverse events, work loss and medical care visits than the non-discography group. The increased cost for surgery and imaging among the discography group was greater than $9,000 per patient.

The second study focused on the impact of epidural steroid injections on patient outcomes. The researchers examined 69 patients who received ESI and 207 patients who did not receive ESI. Patients who received ESI had significantly less improvement over the four-year study period, regardless of whether the patient was treated surgically or non-surgically for their pain.

The third study focused on treatment for thoracolumbar burst fractures with thoracolumbosacral orthosis and early ambulation, which is a time-consuming, expensive and uncomfortable procedure. Of the 47 patients enrolled in the TLSO group and 49 patients enrolled in the no-orthosis group, there was no difference in length of hospital stay or outcomes at any of the follow-up periods. The researchers also found no difference in average kyphotic deformity between the groups.



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