Journal Reports The Spine Journal editors present abstracts from selected articles which may be of interest to TSJ readers. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in primary care. Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in primary care. J Pain 2011;12(9):964–73. Epub 2011 Jun 16 Pain and depression are the most prevalent physical and psychological symptom-based disorders, respectively, and co-occur 30 to 50% of the time. However, their reciprocal relationship and potentially causative effects on one another have been inadequately studied. Longitudinal data analysis involving 500 primary care patients with persistent back, hip, or knee pain were enrolled in the Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study. Half of the participants had comor- bid depression and were randomized to a stepped care intervention (n5123) or treatment as usual (n5127). Another 250 nondepressed pa- tients with similar pain were followed in a parallel cohort. Outcomes were assessed at baseline, 3, 6, and 12 months. Mixed effects model repeated measures (MMRM) multivariable analyses were conducted to determine if change in pain severity predicted subsequent depression severity, and vice versa. Change in pain was a strong predictor of subsequent depression severity (t-value56.63, p ! .0001). Likewise, change in depression severity was an equally strong predictor of subsequent pain severity (t-value57.28, p ! .0001). Results from the full cohort were similar in the clinical trial sub- group. In summary, pain and depression have strong and similar effects on one another when assessed longitudinally over 12 months. PERSPECTIVE: This study strengthens the evidence for a bidirectional and potentially causative influence of pain and depression on one another. A change in severity of either symptom predicts subsequent severity of the other symptom. Thus, recognition and management of both conditions may be warranted, particularly when treatment focused on 1 condition is not leading to an optimal response. Published by Elsevier Inc. PMID: 21680251 [PubMed - in process. Available at: http://www.ncbi. nlm.nih.gov/pubmed/21680251]. Reprinted from: Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitu- dinal analysis in primary care. J Pain 2011;12(9):964–73. Epub 2011 Jun 16, with permission from American Pain Society. doi: 10.1016/j.spinee.2011.12.010 Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the National Surgical Quality Improvement Program. Schoenfeld AJ, Ochoa LM, Bader JO, Belmont PJ Jr. J Bone Joint Surg Am 2011;93(17):1577–82 BACKGROUND: This investigation sought to identify risk factors for immediate postoperative morbidity and mortality among a large series of patients undergoing spine surgery who were prospectively entered into a national registry. METHODS: The database of the National Surgical Quality Improve- ment Program was queried to identify all patients undergoing spine surgery in the years 2005 to 2008. Demographic data, comorbidities, medical history, body-mass index, and the type of procedure performed were obtained for all patients. Postoperative complications and mortality within thirty days after the spinal procedure were also documented. The chi-square test and univariate and multivariate logistic regression analyses were used to evaluate the effect of individual risk factors on mortality, as well as the probability of the development of complications. RESULTS: From 2005 to 2008, 3475 patients undergoing spine surgery were registered in the database. The average age of patients was 55.5 years (range, sixteen to ninety years), and 54% of the cohort were men. Ten pa- tients (0.3%) died after surgery, and there were 407 complications in 263 patients (7.6%). Increased patient age and contaminated or infected wounds were identified as independent predictors of mortality. Increased patient age, cardiac disease, preoperative neurologic abnormalities, prior wound infection, corticosteroid use, history of sepsis, American Society of Anesthesiologists classification of O 2, and prolonged operative times were independent predictors for the development of one or more complications. CONCLUSIONS: Patient age, female sex, longer procedural times, and several types of medical comorbidities influenced the risk of postoperative complications or mortality. This information enhances estimates of mor- bidity and mortality following spine surgery and may improve patient selection for spine surgery as well as preoperative discussions related to the risks of spine surgery. PMID: 21915571 [PubMed - indexed for MEDLINE. Available at: http:// www.ncbi.nlm.nih.gov/pubmed/21915571]. Reprinted with permission from: Schoenfeld AJ, Ochoa LM, Bader JO, Belmont PJ Jr. Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the National Surgical Quality Improvement Program. J Bone Joint Surg Am 2011;93(17):1577–82. Available at: http://www.jbjs.org/article.aspx? volume593&page51577. doi: 10.1016/j.spinee.2011.12.011 The effect of lumbosacral manipulation on corticospinal and spinal reflex excitability on asymptomatic participants. Fryer G, Pearce AJ. J Manipulative Physiol Ther 2011 Oct 28. [Epub ahead of print] OBJECTIVE: The aim of the study was to examine the effects of a high- velocity, low-amplitude (HVLA) manipulation to the lumbosacral joint on corticospinal excitability, as measured by motor evoked potentials (MEPs) using transcranial magnetic stimulation, and spinal reflex excitability, as measured by the Hoffman reflex (H-reflex). The Spine Journal 12 (2012) 84–87