SynthesisBMC neurology2013
Surgery and risk for multiple sclerosis: a systematic review and meta-analysis of case-control studies.
Synthesis in BMC neurology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Association of adverse childhood experiences with adulthood multiple sclerosis: A systematic review of observational studies.Brain and behavior · 2023Pooled it
- Adenotonsillectomy is associated with increased risk and disease activity in pediatric-onset multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026Article
- Acute neurological deficit following lumbar microdiscectomy: a multiple sclerosis relapse mimicking a surgical complication - a case report and literature review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Impact of surgery in patients with multiple sclerosis: a nationwide cohort study.Frontiers in neurology · 2025Article
- Review
- MALTectomy and psoriasis risk in women: A prospective study in the French E3N prospective cohort.PloS one · 2024Observational
- Environmental risk factors of multiple sclerosis in the Middle East and North Africa region: A systematic review.Current journal of neurology · 2021Review
- Onset Symptom Clusters in Multiple Sclerosis: Characteristics, Comorbidities, and Risk Factors.Frontiers in neurology · 2021Article
- Risk Factors Associated with Multiple Sclerosis: A Case-Control Study in Damascus, Syria.Multiple sclerosis international · 2021Article
- Appendectomy, Tonsillectomy and Parkinson's Disease Risk: A Swedish Register-Based Study.Frontiers in neurology · 2020Article
- Oral hormone pregnancy tests and the risks of congenital malformations: a systematic review and meta-analysis.F1000Research · 2018Article
- Environmental exposures and the risk of multiple sclerosis investigated in a Norwegian case-control study.BMC neurology · 2014Article
- Early comorbidities and diagnostic challenges in people with multiple sclerosis with possible impact on disease management.Multiple sclerosis journal - experimental, translational and clinicalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough the precise etiology of multiple sclerosis is largely unknown, there is some speculation that a prior history of surgery may be associated with the subsequent risk for developing the disease. Therefore, we aimed to examine surgery as a risk factor for the diagnosis of multiple sclerosis.
methodsWe searched for observational studies that evaluated the risk for developing multiple sclerosis after surgery that occurred in childhood (≤ 20 years of age) or "premorbid" (> 20 years of age). We specifically included surgeries classified as: tonsillectomy, appendectomy, adenoidectomy, or "surgery". We performed a systematic review and meta-analyses and calculated odds ratios (OR) and their 95% confidence intervals (CIs) using a random effects model.
resultsWe identified 33 case-control studies, involving 27,373 multiple sclerosis cases and 211,756 controls. There was a statistically significant association between tonsillectomy (OR = 1.32, 95% CI 1.08-1.61; 12 studies, I(2) = 44%) and appendectomy (OR = 1.16, 95% CI 1.01-1.34; 7 studies, I(2) = 0%) in individual's ≤ 20 years of age and the subsequent risk for developing multiple sclerosis. There was no statistically significant association between risk for multiple sclerosis and tonsillectomy occurring after age 20 (OR = 1.20, 95% CI 0.94-1.53; 9 studies, I(2) = 32%), in those with appendectomy at > 20 years (OR = 1.26, 95% CI 0.92-1.72; 5 studies, I(2) = 46%), and in those with adenoidectomy at ≤ 20 years of age (OR = 1.06, 95% CI 0.68-1.68; 3 studies, I(2) = 35%). The combined OR of 15 studies (N = 2,380) looking at "surgery" before multiple sclerosis diagnosis was not statistically significant (OR = 1.19, 95% CI 0.83-1.70; I(2) = 71%).
conclusionsWe found a small but statistically significant and clinically important increased risk for developing multiple sclerosis, in those with tonsillectomy and appendectomy at ≤ 20 years of age. There was no convincing evidence to support the association of other surgeries and the risk for multiple sclerosis. Well-designed prospective etiological studies, pertaining to the risk for developing multiple sclerosis, ought to be conducted and should include the examination of various surgeries as risk factors.
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