In Reply: In response to Dr Ratliff and colleagues, in this study our emphasis was on the discordance between spine-related expenditures and self-reported health status. During the study years 1997 to 2005, costs increased; instead of improvements, we noted worsening in physical limitations, work limitations, and social limitations and no improvement in scores on the 12-Item Short Form Health Survey. The diverging trends of increasing costs and worsening function should stimulate discussion regarding efficient use of scarce health care resources.
Mirza SK, Deyo RA, Martin BI. Spine-Related Expenditures and Self-reported Health Status—Reply. JAMA. 2008;299(22):2627-2628. doi:10.1001/jama.299.22.2627-b