ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2014
The influence of comorbidity on the risks and benefits of spine surgery for degenerative lumbar disorders.
Article in 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, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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.
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Who cites it
34 citing papers in PubMed, 72 citations in OpenAlex.
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- Disease-modifying anti-rheumatic drugs are associated with increased readmission and reoperation rates following anterior cervical discectomy and fusion: a propensity-matched cohort study.Journal of spine surgery (Hong Kong) · 2026Article
- Irritable bowel syndrome and its impact on utilization and outcomes in elective thoracolumbar fusion.Brain & spine · 2026Article
- The Core Outcome Measures Index (COMI) comes of age: 18 years of efficient and effective patient-reported outcome measurement in the field of spinal disorders. Part 1. Development of the COMI, interpretation of scores, and use in research.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 · 2025Review
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- Anterior lumbar interbody fusion: patient selection and workup.Journal of spine surgery (Hong Kong) · 2024Review
- Variations in surgical practice and short-term outcomes for degenerative lumbar scoliosis and spondylolisthesis: do surgeon training and experience matter?International journal for quality in health care : journal of the International Society for Quality in Health Care · 2024Observational
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- Comparing 30-Day Outcomes After Emergent Spine Procedures Performed "During Hours" vs "After Hours".International journal of spine surgery · 2023Article
- Crosswalk between Charlson Comorbidity Index and the American Society of Anesthesiologists Physical Status Score for Geriatric Trauma Assessment.Healthcare (Basel, Switzerland) · 2023Article
- Comorbidity data collection across different spine registries: an evidence map.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 · 2023Review
- Evaluating Screw Stability After Pedicle Screw Fixation With PEEK Rods.Global spine journal · 2023Article
- Increasing Patient Complexity Is Associated With Longer In-Hospital Lengths of Stay and Higher Rates of Medical Complications Following Primary 1- to 2-Level Lumbar Fusion.International journal of spine surgery · 2022Article
- Osteopenia and Sarcopenia as Potential Risk Factors for Surgical Site Infection after Posterior Lumbar Fusion: A Retrospective Study.Microorganisms · 2022Article
- External Validation of the European Spine Study Group-International Spine Study Group Calculator Utilizing a Single Institutional Experience for Adult Spinal Deformity Corrective Surgery.International journal of spine surgery · 2022Article
- Is Sarcopenia a Risk Factor for Postoperative Surgical Site Infection After Posterior Lumbar Spinal Fusion?International journal of spine surgery · 2022Article
- Association of Medical Comorbidities With Objective Functional Impairment in Lumbar Degenerative Disc Disease.Global spine journal · 2022Article
- Effect of Preoperative Parameters on Outcomes of Lumbar Microdiscectomy: A Retrospective Analysis.Asian journal of neurosurgery · 2022Article
- Predictors of Complications and Unfavorable Outcomes of Minimally Invasive Surgery Treatment in Elderly Patients With Degenerative Lumbar Spine Pathologies (Case Series).Frontiers in surgery · 2022Article
- Development of a model to predict the probability of incurring a complication during spine surgery.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 · 2021Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe ageing of the population will see a growing number of patients presenting for spine surgery with appropriate indications but numerous medical comorbidities. This complicates decision-making, requiring that the likely benefit of surgery (outcome) be carefully weighed up against the potential risk (complications). We assessed the influence of comorbidity on the risks and benefits of spine surgery.
methods3,549/4,053 patients with degenerative lumbar disorders, undergoing surgery with the goal of pain relief, completed the multidimensional Core Outcome Measures Index (COMI; scored 0-10) before and 12 months after surgery. At 12 months postoperatively, they also rated the global treatment outcome and their satisfaction with care. Using the Eurospine Spine Tango Registry, surgeons documented surgical details, American Society of Anesthesiologists comorbidity (ASA) grades and perioperative surgical and general complications.
results29.0% patients were rated as ASA1 (normal healthy), 45.7% as ASA2 (mild/moderate systemic disease), 24.9% as ASA3 (severe), and just 0.4% as ASA4 (life-threatening). In going from ASA1 to ASA3 (ASA4 group too small), surgical complications increased significantly from 5.0 to 14.5% and general complications increased from 2.9 to 15.7%; 12-month outcomes showed a corresponding decline, with a good global outcome being reported by 79% ASA1 patients, 76% ASA2, and 68% ASA3. Satisfaction with treatment was 87, 85, and 79%, respectively, and reduction in COMI was 4.2 ± 2.9, 3.7 ± 3.0, and 3.4 ± 3.0 points, respectively. Multiple regression analysis revealed a significant (p < 0.0001) independent effect of ASA grade on both complications and outcome.
conclusionThe negative impact of comorbidity on the outcome of spine surgery has not been well investigated/quantified to date. The ASA grade may be helpful in producing algorithms for decision-making and preoperative counselling regarding the corresponding risks and benefits of surgery.
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