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1. Mroz TE, Lubelski D, Williams SK, et al. Differences in the surgical treatment of recurrent lumbar disc herniation among spine surgeons in the United States. Spine J. 2014;14(10):2334–43. doi:10.1016/j.spinee.2014.01.037.

The authors conducted an electronic survey to assess practice-based differences in the treatment of recurrent lumbar disc herniations among neurologic and orthopedic spine surgeons in the United States. The survey was delivered to 2,560 surgeons, with an 18% response rate. The authors document the wide variability in the treatment choices for 2 clinical scenarios regarding recurrent disc herniation. There was a 69% probability that two randomly selected spine surgeons would disagree on the surgical treatment of two-time recurrent herniation.

While the editors of the journal note in their boxed summary of the article the low response rate as a significant limitation, it is worth noting that 15-20% response rates for external surveys are quite typical. If it had been a 5% response rate, I would be more skeptical of the conclusions.

This study is a nice corroboration of prior work looking at surgical choices, and the wide variety of surgical procedures that may be used for any one disease.

See: Lee JY, Hohl JB, Fedorka CJ, et al. Surgeons agree to disagree on surgical options for degenerative conditions of the cervical and lumbar spine. Spine. 2011;36(3): E203–12. doi:10.1097/BRS.0b013e3181df8063

2. Ea H-K, Lioté F. Diagnosis and clinical manifestations of calcium pyrophosphate and basic calcium phosphate crystal deposition diseases. Rheumatic Disease Clinics of North America. 2014;40(2):207–29. doi:10.1016/j.rdc.2014.01.011.
Calcium pyrophosphate (CPP) and basic calcium phosphate (BCP) crystals are the 2 main families of calcium-containing crystals that may form simultaneously in joint structures, ligament, tendon, muscle, and soft tissue.

This review covers in detail the pathophysiology and diagnosis of all the systemic manifestations of these crystal deposition diseases. Of particular interest for neuroradiology is the discussion of crowned dens syndrome, longus colli calcific tendinitis, and compression from crystal deposition leading to canal stenosis or myelopathy.

3. Griessenauer CJ, Raborn J, Foreman P, Shoja MM, Loukas M, Tubbs RS. Venous drainage of the spine and spinal cord: A comprehensive review of its history, embryology, anatomy, physiology, and pathology. Clin Anat. 2015;28(1):75–87. doi:10.1002/ca.22354.

Not much is present in the current literature regarding the venous system of the spinal cord. This review presents some welcome information, despite the non-user-friendly formatting of the text into overly large paragraphs.   I suggest you start with page 77, and the “intrinsic system” and skip the embryology part….. unless you love that stuff. Seven figures included.

4. Klink T, Geiger J, Both M, et al. Giant Cell Arteritis: Diagnostic Accuracy of MR Imaging of Superficial Cranial Arteries in Initial Diagnosis-Results from a Multicenter Trial. Radiology. 2014;273(3):844–52. doi:10.1148/radiol.14140056.

The authors evaluated the utility of high-resolution fat saturated contrast enhanced MR for the diagnosis of giant cell arteritis (GCA), specifically looking at arterial wall enhancement. Sensitivity was 88.7%, and specificity was 75.0% for the group that had temporal artery biopsy. Diagnostic accuracy of MR imaging was high in patients without steroid therapy for 5 days or fewer. They conclude that contrast-enhanced MR imaging is accurate and reproducible in the noninvasive, initial diagnosis of GCA. Symmetric and simultaneous inflammation is the typical involvement pattern in GCA.

5. Marcus A, Oransky I. What Studies of Retractions Tell Us. Journal of Microbiology and Biology Education. 2014;15(2):151–154. doi:10.1128/jmbe.v15i2.855.

For interesting reading, try http://retractionwatch.com.

What do we know about retractions?

1. They are increasing in number.
2. Misconduct accounts for 2/3 of retractions. Not just honest errors anymore.
3. Editors don’t like retractions; they are messy.
4. The quality of the retraction notices vary widely and often do not give the sense of whether the retraction occurred because of misconduct or honest error.
5. Retractions are hard to find, and the papers that have been retracted are often still available without the appropriate retraction notice.
6. They are more common in high impact factor journals and more common in biology and medicine.
7. Career detrimental effect does exist for the authors of retracted papers, but seemingly only for or the mid- and low-level scientist. For leaders in the field, the career effect is minimal.

6. Bastian H. A Stronger Post-Publication Culture Is Needed for Better Science. PLoS Med. 2014;11(12):e1001772. doi:10.1371/journal.pmed.1001772.

This is an interesting commentary on the need for more participation, openness and transparency in post publication commenting and post publication peer review (not the same things!). The utility of post publication commenting/review is complicated by the many goals that are espoused from these systems. Are you trying to replace formal pre-publication peer review entirely with post publication review? Are you trying to supplement pre-publication review? Are you trying to catch unethical science and force retractions? Do you just want to discuss the research with the authors to help your research move forward?

The classic commenting system for academic publishing has been the letter to the editor, with a subsequent author response letter that may be spread out over a time period of many months. The presence of social media, forums and commenting systems inherent in the transition to digital publishing allow many more opportunities for post-publication review and comment. While an important and lofty goal, in practice, post-publication peer review has been a non-starter. One study showed that 82% of articles received no comments. This lack of participation is seen by both sides of the publication spectrum, with lack of reviews and comments from readers, and lack of response from authors to those comments.   This general apathy is probably a combination of the general limited of bandwidth of the audience, and the lack of any positive reinforcement for engaging in such tasks since they are of no interest to academic promotions committees.

7. Nash RA, Hutton GJ, Racke MK, et al. High-Dose Immunosuppressive Therapy and Autologous Hematopoietic Cell Transplantation for Relapsing-Remitting Multiple Sclerosis (HALT-MS): A 3-Year Interim Report. JAMA Neurol. 2014. doi:10.1001/jamaneurol.2014.3780.

Hematopoietic Cell Transplantation for Relapsing-Remitting Multiple Sclerosis (HALT-MS) is an ongoing, multicenter, single-arm, phase 2 clinical trial of high-dose immunosuppressive therapy (HDIT) with autologous hematopoietic cell transplant (HCT) for patients with relapsing-remitting multiple sclerosis (RRMS). The paper presents the prespecified, 3-year interim analysis of this trial.

Thirty-six patients with RRMS were screened, and 25 were enrolled. At 3 years, HDIT/HCT without maintenance therapy was effective in inducing sustained remission of active RRMS and was associated with improvements in neurologic function. Event-free survival was estimated to be 82.8% at 2years and 78.4% at 3years after HCT. For CD4+ T cells, dominant T-cell receptor clones that were present before treatment were not detectable following reconstitution, and patients usually developed a new repertoire consistent with an “immune reset”. Adverse events were hematologic or gastrointestinal, which were considered expected and reversible. No early treatment-related mortality or organ failure occurred.

8. Wu A-M, Zhou Y, Li Q-L, et al. Interspinous spacer versus traditional decompressive surgery for lumbar spinal stenosis: a systematic review and meta-analysis. PLoS One. 2014;9(5):e97142. doi:10.1371/journal.pone.0097142.

Dynamic devices such as interspinous spacers have been designed to limit spinal extension. These include the X-stop, Coflex, DIAM, and Aperius devices. This systematic review had inclusion criteria of: (1) a randomized controlled trial (RCT) or non-randomized prospective comparison study, (2) comparing the clinical outcomes of interspinous spacer use versus traditional decompressive surgery, (3) minimum of 30 patients, (4) follow-up duration of at least 12 months. Two RCTs and three non-randomized prospective studies were included. The authors concluded that interspinous spacer use is associated with a higher incidence of reoperation and higher cost. The meta-analysis revealed no statistically significant differences in the clinical outcomes for back/leg pain between the two groups. Reoperation rate was significantly higher in the interspinous spacer group (23.0%) compared to the standard decompression group (6.9%).

These devices, along with the lumbar total disc replacements, seem to have peaked in utilization 3-5 years ago. The bulk of the literature seems to have turned against the interspinous spacers as a group.