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A 2024 critical review noted that unexpectedly high B12 levels can be further investigated by a clinician if needed, preferably by directly measuring the carrier proteins haptocorrin and transcobalamin rather than relying on the commonly ordered PEG precipitation test, which the authors found nonspecific and potentially misleading (Fedosov, 2024)
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Additional lumbar fusion surgery improved the gait, and 9 years and 5 months after lumbar fusion surgery spasticity continued to be well controlled with ITB therapy
