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Study design Retrospective review. Objective To ascertain impact of preprocedural magnetic resonance imaging (MRI) or nuclear medicine Tc99m-DMP scintigraphy on the treatment plan when compared with plain films and/or computed tomography prior to vertebral augmentation procedures. Summary of background data Over 1 million vertebral compression fractures (VCFs) occur in the United States annually with over 150,000 individuals hospitalized each year. Physical examination and history are essential to the workup of VCFs, but imaging remains necessary for confirming the diagnosis. VCFs can be imaged with various modalities and there is limited data on the comparative effectiveness of different imaging modalities. Methods Six hundred fifty consecutive patients treated with vertebral augmentation at a single institution between May of 2013 and April of 2018 were reviewed. Preprocedure imaging of the spine obtained within 30 days prior to the procedure were reviewed. Preprocedure imaging results were cross-referenced against the levels treated by vertebral augmentation to determine whether there was a change in the levels treated after receiving an MRI or NM imaging study. Results Three hundred sixty-three patients had adequate imaging for inclusion. One hundred fifty-four of these 363 patients (42.4%) had an alteration of their treatment plan based upon the MR or NM imaging. Fewer vertebral levels were treated in 33, different levels were treated in 41, and more levels were treated in 80 patients. Conclusion MRI or nuclear medicine bone scan imaging prior to vertebral augmentation altered the location and number of levels treated in a large percentage of patients, adding specificity to treatment over findings on radiographs or computed tomography alone. Level of evidence 3.

Hunting is an important source of economic activity for rural South Texas. However, little is known about the economic impacts associated with landowner expenses. Questionnaires were mailed to landowners across the South Texas region to collect expense data related to managing hunting operations. The data included expense information on 248 ranches and encompassed 692,564 hunted hectares. The software IMPLAN was used to calculate the economic impact of these expense data. Total expenditures for the region were an estimated $114.4 million. Landowners who responded to our survey (n = 200) generated an estimated $166.1 million in economic output. With a direct impact of $108.9 million, the total value added to the South Texas economy was an estimated $75.7 million, which supported 1,635 jobs. Landowner expenditures contribute significantly to the economy of the South Texas region and should be a consideration of those who maintain or create policy that impacts wildlife conservation in the region.