AANEM Practice News Express

AANEM News Express

Systematic Review and Meta-analysis of ESIs for Radiculopathy and Spinal Stenosis

This review in the Annals of Internal Medicine of 30 placebo-controlled trials on epidural corticosteroid injections (ESIs) for radiculopathy and 8 trials for spinal stenosis calls into question the increasing use of ESIs for common diagnoses of radiculopathy and spinal stenosis.

Safety and Efficacy of Diaphragm Pacing in ALS Patients

Effective treatments for ALS are aggressively sought, and diaphragmatic pacing received expedited approval by the US FDA based on a single multi-center study. This study in Lancet Neurology, however, demonstrated that diaphragmatic pacing reduced survival in ALS patients.

CIDP diagnostic pitfalls and perception of treatment benefit

This important study from Neurology demonstrates the troubling frequency with which patients are misdiagnosed with CIDP and even treated with immunotherapy. Neuromuscular subspecialty referral and closer adherence to published guidelines would reduce this problem considerably, though likely not eliminate it.

Guideline Released for Facioscapulohumeral Muscular Dystrophy (FSHD)

A new guideline from the American Academy of Neurology (AAN) and the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) looks at the scientific studies on facioscapulohumeral muscular dystrophy (FSHD).  This new guideline is based on the best available studies on FSHD, and can inform the public and clinicians about the best approach to managing and treating this disease. 

2016 Medicare Physician Fee Schedule: Proposed Rule Released

On July 8, 2015, CMS issued a
proposed rule updating payment policies, rates, and quality provisions for physicians under the Medicare Physician Fee Schedule (MPFS) in 2016.  According to the proposed rule, CMS projects minimal impact on neuromuscular and electrodiagnostic physicians.

UPDATE: “Job Descriptions for NCS Technologists”

The AANEM Professional Practice Committee, in coordination with members of the AANEM Technologist Education Committee, recently revised AANEM’s prior position statement, “
Job Descriptions for Electrodiagnostic Technologists.”  The new version of the position statement, “Job Descriptions for NCS Technologists,” goes into much greater detail and adds many more levels of classification for technologists working in electrodiagnostic (EDX) laboratories.

SPORT and Spine: Long-term Outcomes of Lumbar Spinal Stenosis

Spine Patient Outcomes Research Trial (SPORT) is a very large randomized trial with a concurrent observational cohort study that involved 13 spine centers in 11 US states. Part of the study compared the outcomes of surgery (decompressive laminectomy) with non-operative care for symptomatic lumbar spinal stenosis. This study points out the possibility that surgical treatment for lumbar spinal stenosis may not have long-term benefit past 4 years. 

JAMA Study: Steroid Injection Not Helpful for Knee Osteoarthritis

Knee OA is a frequent cause of pain and disability, with one of the standard treatments being IA steroid injection. This JAMA study showed no clinical benefit of 40 mg methylprednisolone acetate compared to placebo of saline with lidocaine when combined with exercise, raising doubt about the standard of care and presumed benefit of steroid injection for knee OA. 

Interesting Results Found in Study on Cervical MRIs of Asymptomatic People

Ever wonder what you would find if you did cervical MRIs on asymptomatic people? The results of this study from Japan alert us to the fact that interventional decisions made by judging degenerative changes on MRI alone can be mistake-ridden and dangerous, and that clinical decisions should be prudent, correlating MRI findings with clinical signs and symptoms. 






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