Summary of Key Points Appropriate use criteria are developed to define which patients certain medical and surgical procedures are appropriate for and when the benefits sufficiently exceed the risks, thus making the procedure worth doing. The RAND Corporation/University of California…
Summary of Key Points Clinical practice guidelines have become an integral part of the practice of medicine. They are here to stay and will continue to inform clinical practice. Important resources exist to help with the formation of these guidelines…
Summary of Key Points Confounders in clinical investigation are systematic errors that cause a tendency toward erroneous results. The two major forms of bias in retrospective studies are selection bias and missing data. Case-control studies are used to identify factors…
Summary of Key Points The randomized controlled trial (RCT) is the gold standard in evidence-based medicine. Surgical RCTs can be affected by several types of bias, including informational bias, which occurs owing to a lack of blinding, and response bias,…
Summary of Key Points A conflict of interest is defined as “a set of conditions in which professional judgment concerning a primary interest (such as a patient’s welfare or the validity of research) tends to be unduly influenced by a…
Summary of Key Points Registries and databases provide opportunities to capture “real-world” data. Capturing and studying “real world” outcomes of routinely performed spine surgery has a two-fold advantage: It allows us to optimize patient outcomes by identifying drivers of adverse…
Summary of Key Points Medicine is generating approximately a quintillion bytes of data every day, and within those admittedly disorganized, unstructured, or uncurated data streams are transformative insights about patient care and disease treatment. “Big Data” systems, which include advanced…
Summary of Key Points Effective management of spinal wounds require a thorough understanding of the soft tissue anatomy of the back. The basis for avoiding spinal wound complications relies on basic surgical principles, such as a clean, vascularized wound, organized…
Summary of Key Points Vascularized bone grafts combine structural properties with biological enhancement through vascularization. Common indications for vascularized bone grafts include: Bone graft greater than 5 cm Strut graft that will be more than 4 cm from the anterior…
Summary of Key Points The gold standard for fusion substrates in spine surgery has historically been autogenous bone, particularly that of the iliac crest because of its readily available supply of both cortical and cancellous bone. Iliac crest bone graft…