Racial Disparities Exist in Outcomes of Spinal Surgery

The rate of complications, length of stay, and costs associated with surgery for lumbar spinal stenosis differ for African-American patients compared with white patients.

Rate of Rheumatoid Arthritis Remission Down for Overweight Patients

For patients with early rheumatoid arthritis, being overweight or obese is associated with an increased likelihood of not achieving remission.

Rheumatoid Arthritis Patients Discontinue Meds at Median of Two Years

For patients with rheumatoid arthritis, the median time to discontinuation of therapy is 25.1 months, with longer time to discontinuation noted for those receiving tumor necrosis factor inhibitors.

Neurological Testing Limited in Diagnosing Disc Herniation

Neurological testing procedures have limited diagnostic accuracy for detecting disc herniation with suspected radiculopathy.

Knee, Hip Replacement Outcomes Compared with Arthritis

Patients with rheumatoid arthritis undergoing total knee replacement have outcomes at two years similar to those seen in patients with osteoarthritis; while for total hip replacement, two-year pain and function is significantly worse for those with rheumatoid arthritis vs. osteoarthritis.

Marked Variability Seen in Total Knee Arthroplasty Indications

There is considerable variability associated with total knee arthroplasty recommendations.

Xgeva Approved for Giant Cell Tumor of the Bone

Xgeva (denosumab; Amgen) has been approved for the treatment of unresectable giant cell tumor of the bone (GCTB) in adult and adolescent patients.

Simponi 5-Year Data Shows Improvement in Majority of RA Patients

Janssen Biotech announced data from three Phase 3 trials, GO-FORWARD, GO-BEFORE, and GO-AFTER evaluating Simponi 50mg administered subcutaneously once every four weeks in the treatment of moderately to severely active rheumatoid arthritis.

Cervical Disc-Level Canal Diameter Predicts Spinal Injury

Disc-level canal diameter determined from magnetic resonance imaging can identify patients at risk for acute spinal cord injury after minor trauma.

Oral Apremilast Shows Positive Long-Term Data in Psoriatic Arthritis

Celgene announced positive long-term data from PALACE 1, the first of four Phase 3 studies evaluating patients with psoriatic arthritis.

Orencia Comparable to Humira in Rheumatoid Arthritis

Results from a Phase 3b head-to-head study showed that abatacept had comparable efficacy to adalimumab in patients with active moderate-to-severe rheumatoid arthritis.

Lumbar Epidural Steroid Injections Up Risk of Spinal Fractures

In patients with radiculopathy or neurogenic claudication due to compression of spinal nerves, lumbar epidural steroid injections increase the risk of vertebral fractures.

Surgical Methods Compared for Degenerative Spondylolisthesis

For patients with multilevel lumbar stenosis and single-level degenerative spondylolisthesis (DS), surgical outcomes are not significantly different with decompression and single-level or multilevel fusion.

MRI Identifies Compression Fractures Before Cementing

In patients with suspected vertebral compression fractures, the addition of magnetic resonance imaging (MRI) reduces the rate of misdiagnosis of acute lesions and hidden lesions before percutaneous cement augmentation procedures.

Pre-Op Depression Skews Satisfaction After Lumbar Surgery

Preoperative depression influences self-reported patient satisfaction after revision lumbar surgery, independent of the surgery's effectiveness.

Meta-Analysis Compares Vascular Risks for NSAIDs

The nonsteroidal anti-inflammatory drug (NSAID) diclofenac is associated with significantly increased vascular risk, comparable to that of selective COX-2 inhibitors (coxibs).

Morbid Obesity Complicates Treatment of Spine Trauma

Morbid obesity complicates treatment of spine trauma, including imaging quality, surgical challenges, and postoperative nursing care.

FDA Designates First Hypophosphatasia Drug Breakthrough Therapy

The FDA has granted Alexion's first-in-class enzyme replacement therapy, asfotase alfa, breakthrough therapy designation for the treatment of patients with hypophosphatasia.

Recall: Particulate Discovered in Methotrexate Vials

Sandoz is recalling two lots of Methotrexate Sodium injectable after discovering particulate matter in the vials.

Vitamin C Deemed Ineffective as Therapy for Gout

Short-term therapy with vitamin C at modest doses did not have a clinically significant effect on lowering urate levels in patients with gout.

Lifestyle Activities Impact Development of Spinal Stenosis

Increased loading of the lumbar spine, arising from lifestyle activities, could contribute to the degenerative process and lead to development of degenerative lumbar spinal stenosis.

Discectomy Post-Op Pain Worse in Patients With Retrolisthesis

The presence of retrolisthesis in patients undergoing decompressive surgery for a lumbar disc herniation may result in significantly worse lower back pain and physical function over four years.

Combination Therapy Improves Bone Density with Osteoporosis

Combination therapy with teriparatide and denosumab may be most effective in treating postmenopausal women with osteoporosis at risk for fracture.

Ultrasound Findings Can Improve Rheumatoid Arthritis Classification

Compared to clinical diagnosis of synovitis, ultrasound-detected synovitis provides either improved sensitivity or specificity when used with the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for identifying patients with a disease requiring methotrexate (MTX) treatment.

Self-Image Worse for Teens With Untreated Scoliosis

Adolescents with untreated adolescent idiopathic scoliosis report worse pain and worse self-image than unaffected adolescents, although the difference is clinically significant only for self-image.

FDA Says Ilaris OK for Childhood Arthritis

Ilaris is the first interleukin-1 beta inhibitor approved for the treatment of systemic juvenile idiopathic arthritis.

Joint Supplement Contains Undeclared Allergens

Atriphen has been recalled due to the possibility of causing a severe allergic reaction from two undeclared allergens.

Magnesium, Not Calcium, Linked to Bone Mineral Status

Magnesium, but not calcium, intake seems to be associated with total bone mineral content and density among young children.

Diabetes, Hypertension Prevalent With Spinal Stenosis

Nonelderly, older adults with lumbar spinal stenosis have a higher prevalence of diabetes and hypertension than those without stenosis.

Nearly One-Third Don't Pick Up New Osteoporosis Rx

>30% of women fail to pick up new prescriptions for osteoporosis medications.

Neuraxial Bests General Anesthesia in Arthroplasty

In patients undergoing primary joint arthroplasty, neuraxial anesthesia is associated with better postoperative outcomes than general anesthesia.

Risk Factors ID'd for Scoliosis Surgery Complications

Increases in the upper thoracic scoliotic curve, thoracic kyphosis, and number of rod-lengthening procedures are risk factors for postoperative complications associated with growing-rod (GR) surgery for early-onset scoliosis (EOS).

Standard Criteria Needed for Spinal Stenosis Diagnosis

There is a need for a consensus on criteria to define and classify lumbar spinal stenosis.

Even Light Smoking Increases Risk of Rheumatoid Arthritis in Women

Even light smoking increases the risk of rheumatoid arthritis among women, and smoking cessation reduces but does not eliminate this risk.

Ultrasound Model IDs Residual Joint Inflammation in Rheumatoid Arthritis

A model including ultrasound assessment of the wrist, metacarpophalangeal, ankle, and metatarsophalangeal joints is highly sensitive for detecting B-mode and Doppler joint inflammation in patients with rheumatoid arthritis.

Cimzia Starter Kit Now Available for Induction Dosing

UCB announced the introduction of Cimzia Starter Kit for induction dosing. Cimzia is a pegylated anti-TNF indicated for the treatment of adults with moderately to severely active rheumatoid arthritis or Crohn's disease.

Fewer Induced Abortions in RA Patients Exposed to Methotrexate

For women with rheumatoid arthritis, exposure to methotrexate is associated with a reduced risk of induced abortions.

Routine CT Imaging Can Identify Osteoporosis

Abdominal computed tomography imaging, conducted for other indications, can be used to identify patients with osteoporosis.

Re-Op Rates ID'd for Herniated Intervertebral Disc Disease

For patients undergoing surgery for lumbar herniated intervertebral disc disease, reoperation rates reach 13.4% after five years, with more than half of reoperations occurring in the first year.

For People with Osteoarthritis, 'Mobility Shoes' Improve Knee Loading

For patients with knee osteoarthritis, use of flat, flexible footwear (mobility shoes) for six months is associated with significant improvements in knee adduction moment.

Readmission Rates Below 10% After Spine Stenosis Decompression

For patients undergoing lumbar spine stenosis decompression surgery with or without fusion, the one-year readmission rate is 9.7% or 7.2%, respectively.

With Spinal Stenosis, Fusion Doesn't Increase Reoperation Risk

For patients undergoing surgical treatment of spinal stenosis, lumbar fusion and instrumentation do not increase the rate of reoperation at index or adjacent levels compared with nonfusion techniques.

Lumbar Disc Herniation Surgery Is Effective for Octogenarians

For octogenarian patients with lumbar disc herniation, unilateral laminectomy and discectomy seems safe and effective.

Growth Hormone Ups Height in Pediatric Dialysis Patients

For pediatric dialysis patients, growth hormone therapy is associated with an increased rate of bone formation and results in greater increases in height.

Phase 3 Results Promising for Fostamatinib, First Oral SYK Inhibitor for Rheumatoid Arthritis

AstraZeneca announced top-line results for Oral SYK Inhibition in Rheumatoid Arthritis (OSKIRA-1), a Phase 3 study assessing the safety and efficacy of fostamatinib, the first oral spleen tyrosine kinase inhibitor in development for rheumatoid arthritis.

Study: Testosterone Changes Precede Rheumatoid Arthritis in Men

Hormonal changes, especially testosterone, precede the onset of rheumatoid arthritis (RA) in men and may influence the type of RA.

Diabetes Patients Show Less Improvement After Lumbar Spine Surgery

Patients with diabetes who have longstanding diabetes, poor glycemic control, and use insulin had suboptimal improvements in clinical outcomes after lumbar spine surgery.

BLA Submitted for Vimizim; A Treatment for Morquio A Syndrome

BioMarin has submitted a Biologics License Application to the FDA for Vimizim, an enzyme replacement therapy under evaluation for the treatment of patients with rare lysosomal storage disorder Mucopolysaccaridosis Type IVA, also called Morquio A Syndrome.

Five Years Later, Cervical Discectomy & Fusion Is Durable and Cost-Effective

Single-level instrumented anterior cervical discectomy and fusion is durable and cost-effective after five years of follow-up.

Low Vitamin D Levels Common Among Spinal Fusion Patients

A substantially high number of patients undergoing spinal fusion have a vitamin D deficiency or inadequacy.

How Should Short Stature in Childhood Be Treated?

Short stature in childhood warrants evaluation, and various treatment options should be considered.

Majority of Lumbar Spine MRIs Are Inappropriately Ordered

Researchers found substantial overuse of lumbar MRI scans. Less than half of lumbar spine MRIs were considered appropriate, with the remainder either inappropriate or of uncertain value.

High Weight Loss, Muscle Depletion May Predict Cancer Mortality

Cancer patients with high weight loss, low muscle index, and low muscle attenuation have a poor prognosis--regardless of body mass index.

Elevated Blood Cobalt Levels Linked to Metal Hip Failures

Elevated blood cobalt concentrations are associated with an increased risk of early joint failure in metal-on-metal hip resurfacings secondary to the development of an adverse local tissue response.

For Chinese Women, Age of Menarche and Menopause Linked to Cardiovascular Risk

For Chinese women, the age of menarche and menopause is not related to the risk of diabetes, but does correlate with cardiovascular disease and osteoporosis.

Early-Onset Scoliosis Surgery Has High Risk of Mortality, Morbidity

Surgery for patients with early-onset scoliosis is associated with an 18% mortality rate and an 84% complication rate. Patients had been diagnosed with congenital scoliosis, syndromic and chromosomal abnormalities, cerebral palsy, and spinal muscular atrophy.

Total Knee Replacement Poses a Public Health Burden

The prevalence of total knee replacement is estimated at 4.2% for U.S. adults aged 50 years or older. The prevalence increased with age and was higher among females (4.8%) than males (3.4%).

No Link Between Maternal Vitamin D and Child Bone Mineral Content

No association exists between maternal 25-hydroxyvitamin D concentration and bone mineral content in offspring who are 9-10 years old, according to a new study.

One Year After Surgery, MRI Does Not Identify Recurrent Sciatica

For patients treated for sciatica and lumbar-disc herniation, an MRI performed at one year does not distinguish between those with and without favorable outcome.

Use of Da Vinci Robot Expands to Anterior Lumbar Interbody Fusion

Pennsylvania researchers have found that the da Vinci Robotic Surgical System, when used for anterior lumbar interbody fusion, resulted in better visualization inside the disc space and surrounding structures than with current techniques.

Risk Factors ID'd for Massive Blood Loss in Scoliosis Surgery

For patients undergoing scoliosis surgery, the risk of massive blood loss is increased with preoperative Cobb angles above 50 degrees and for those undergoing osteotomy or fusion above 6 levels.

Sleep Meds Up Risk of Hip Fracture Among Nursing Home Residents

A new study shows nursing home residents using a nonbenzodiazepine hypnotic drug are at an increased risk for hip fractures, particularly new users of the drug or those with impairments.

Double-Jointed Adolescents Risk Musculoskeletal Pain

Joint hypermobility (JH) increases the risk of musculoskeletal pain in adolescence, particularly in the shoulder, knee, and ankle/foot.

Anti-TNF Therapy Not Linked to Herpes Zoster Risk in RA

For patients with rheumatoid arthritis (RA) and other inflammatory diseases, use of anti-tumor necrosis factor (TNF) therapy is not associated with an increased risk of herpes zoster.

Steroid Injections May Worsen Spinal Stenosis Outcomes

The use of epidural steroid injections (ESIs) may be linked to worse outcomes over four years in patients with lumbar spinal stenosis whether they are treated surgically or nonsurgically.

Impact of Osteoporosis Tx on Spinal Fusion Unclear

The effect of osteoporosis therapies (bisphosphonate drugs and intermittent parathyroid hormone [PTH]) on spinal fusion is unclear.

Glycemic Control Not Linked to Adverse Outcomes After TKA

For patients undergoing total knee arthroplasty, diabetes (with or without poor glycemic control) is not associated with adverse surgical outcomes.

ACR Releases Five 'Don'ts' for Rheumatologists

As part of the Choosing Wisely campaign, the American College of Rheumatology (ACR) has issued a list of the top five tests and treatments commonly misordered by rheumatologists.

FDA Accepts NDA for Otrexup for Subcutaneous Delivery of Methotrexate

Antares Pharma announced that the FDA has accepted for review their New Drug Application (NDA) for Otrexup, a potential new product for the SQ delivery of methotrexate (MTX) using Medi-Jet technology.

Higher Risk of Hip Implant Failure for Women Than Men

After adjustment, implant failure is more likely for women than men who undergo total hip arthroplasty (THA).

Two Endocrine Disruptors Linked to Osteoarthritis

Higher serum concentrations of two endocrine disrupting chemicals, perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS), are associated with nearly twice the risk of osteoarthritis in women, but not men.

Program Cuts Unnecessary Referrals for Scoliosis in Teens

Implementation of a quality improvement program correlates with a sustained reduction in unnecessary referrals for adolescent idiopathic scoliosis (AIS).

Race Affects Physical Activity Levels in Knee Osteoarthritis

In persons with or at risk for radiographic knee osteoarthritis (RKOA), African-Americans are 72-76% less likely than whites to meet the 2008 United States Department of Health and Human Services (DHHS) Physical Activity Guidelines aerobic component.

General Anesthesia Ups Knee Replacement Complications

For patients undergoing total knee arthroplasty, use of general anesthesia is associated with a significant increase in complications compared with spinal anesthesia.

Most Docs Able to Explain Gaps in Quality of Rheumatology Care

Data from the Physician Quality Reporting System (PQRS) for osteoporosis and rheumatoid arthritis (RA) care in Medicare fee-for-service beneficiaries show that up to one-quarter of physicians provided reasons in the system explaining why care was considered but not provided.

In Veterans With RA, PTSD Worsens Disease Activity

For U.S. veterans with rheumatoid arthritis (RA), a diagnosis of posttraumatic stress disorder (PTSD) is associated with worse patient-reported outcomes and tender joint counts.

Study Explores Link Between UV-B Light Exposure, RA Risk

In a cohort of older women, exposure to ultraviolet-B (UV-B) light is associated with a significantly reduced risk of rheumatoid arthritis (RA), but this relationship is not seen among younger women.

Less Benefit for Obese With Lumbar Disc Herniation Tx

Obese patients derive less benefit from both operative and non-operative lumbar disc herniation treatment.

Risk Factors ID'd for Cervical Spinal Surgery Complications

Risk factors have been identified for medical complications following cervical spine surgery, with cardiac and pulmonary complications correlating with death within two years.

Review Finds Limited Value for Spinal Manipulation in Acute LBP

Spinal manipulative therapy (SMT) is no more effective a treatment for acute low back pain than inert interventions, sham SMT, or as adjunct therapy.

Minimally Invasive, Open Hemilaminectomy Equivalent

Minimally invasive (MIS) and open multilevel hemilaminectomy are similar with respect to cost and improved quality of life measures for the treatment of degenerative lumbar spinal stenosis.

Pre-Op Physiatry Consultation Reduces Spinal Surgery Rates

Requiring patients interested in spinal surgery to first see a rehabilitation physician reduces the number of spinal surgeries, reduces costs, and leaves patients largely satisfied.

More Complications for Inpatient Lumbar Discectomy

Patients undergoing inpatient lumbar discectomy have significantly higher overall complication rates than those treated as outpatients.

July Residency Influx Doesn't Impact Spinal Surgery Outcomes

The July influx of new residents has a minimal effect on peri-procedural outcomes for patients undergoing spinal surgery.

PhysioDirect Equal to Usual Care for Musculoskeletal Issues

For patients with musculoskeletal problems, PhysioDirect, a service which invites patients to telephone a physical therapist for initial assessment and advice, followed by face-to-face physical therapy if necessary, is similarly effective to usual care, but is associated with slightly lower patient satisfaction.

Pedicle Subtraction Osteotomy Better With Two Surgeons

Using a two-surgeon strategy for pedicle subtraction osteotomies is associated with better outcomes.

Substantial Increase in Spinal Interventional Techniques Seen

Between 2000 and 2008, there was a nearly 108% increase in the number of Medicare recipients receiving spinal interventional techniques.

Tofacitinib Slows Joint Damage in Rheumatoid Arthritis

Tofacitinib slows the progression of joint damage and improves disease activity in patients with rheumatoid arthritis (RA).

Poor Arthritis Outcome Risk Up in Overweight Black Women

Overweight African-American women with or at risk of knee osteoarthritis are at higher risk than overweight white women of poor functional outcomes.

Gablofen Prefilled Syringe Approved for Severe Spasticity

Mallinckrodt announced that the FDA has approved Gablofen (baclofen injection) prefilled syringes.

Post-Laminectomy Spine Strength Can Be Predicted

Following lumbar laminectomy, loss of strength and shear stiffness (SS) can be predicted in the human lumbar spinal segment using measurable parameters.

Improved Driving Reaction Times After Lumbar Disc Sx

Driving reaction times (DRTs), which are increased for patients with radiculopathy, improve after lumbar disc surgery.

Vitamin D Does Not Improve Knee OA Progression, Symptoms

For adults with symptomatic knee osteoarthritis (OA), vitamin D supplementation for two years does not reduce knee pain or cartilage volume loss compared to placebo.

Study Questions Effect of Disc Replacement on Low Back Pain

Although total disc replacement for chronic low back pain due to degenerative disc disease yields statistically significant improvements compared to conventional fusion, the clinical relevance is unclear and conclusions regarding effectiveness are hampered by low quality evidence and short follow-up.

Web-Based QoL Tool Beneficial in Juvenile Idiopathic Arthritis

Children with arthritis who use a Web-based application to monitor health-related quality of life (HRQoL) have more discussions with their rheumatologist about psychosocial issues, and their physicians are more satisfied with the care provided during consultations.

Cervical Spine Instabilities Frequently Develop in RA

Nearly half of all patients with rheumatoid arthritis (RA) initially without any cervical spine instabilities will develop some type of instability within about five years.

Fracture Risk Down With Adherence to Bisphosphonates

For patients with an osteoporotic fracture, adherence to bisphosphonate treatment is associated with reduced fracture risk; and for veterans with rheumatoid arthritis, non-adherence to bisphosphonate treatment is >50%.

Surgery Consultation Common After MRI of the Spine

Almost half of patients whose primary care physicians recommend a lumbosacral or cervical spine magnetic resonance imaging (MRI) scan go on to receive a surgical consultation, but few end up undergoing spinal surgery.

EP Studies Helpful in Lumbar Spinal Stenosis Prognosis

Electrophysiological abnormalities have been identified that are of some prognostic value in determining deteriorating clinical status over the long term for patients with mild-to-moderate lumbar spinal stenosis (LSS).

Teen Vitamin D Intake Not Related to Adult RA or SLE Risk

Dietary vitamin D intake during adolescence does not appear to be associated with the risk of adult-onset rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE).