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—It is thoughtful of Dr Derian to update the medical community on important ongoing investigations apparently designed to demonstrate the safety and efficacy of spine instrumentation. If the phrase "increased caution" referrable to the use of spine instrumentation is not accurate, there is at least "increased scrutiny" being applied to such surgery. This scrutiny is taking place with regard to the volume of spine surgery currently being performed as well as the regulatory status of the instrumentation being used. Well-constructed, prospective, controlled studies are important to resolve these areas of concern, and I hope these will be appearing in the peer-reviewed literature in increasing numbers.
Morrey BF. Contempo: Instrumented Spinal Fusions-Reply. JAMA. 1994;271(2):105. doi:10.1001/jama.1994.03510260029021