Evidence map›Paper›PMID 26272373›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2016

Risk factors for adjacent segment pathology requiring additional surgery after single-level spinal fusion: impact of pre-existing spinal stenosis demonstrated by preoperative myelography.

Itaru Yugué, Seiji Okada, Muneaki Masuda, Takayoshi Ueta, Takeshi Maeda, Keiichiro Shiba

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

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, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04467944 (Effect of Pre-existing Adjacent Segment Degeneration on Long-term Effectiveness After Lumbar Fusion Surgery), which is not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04467944 recruitingnot on this mapstarted 2018, after this paper: background citation

Effect of Pre-existing Adjacent Segment Degeneration on Long-term Effectiveness After Lumbar Fusion Surgery: a Prospective Cohort Study

TypeobservationalSponsorPeking University Third HospitalRan2018 to 2032Enrolled210ConditionsDegenerative Lumbar Spinal Stenosis, Degenerative Disc Disease, Degeneration SpineArmsPre-existing degenerative factors at adjacent segment
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Development and validation of explainable machine learning models to predict the risk of adjacent segment disease after lumbar fusion 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 · 2026
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  11. [Effect of pre-existing adjacent segment degeneration on short-term effectiveness after lumbar fusion surgery].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2019
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  13. Survivorship Analysis of Clinical Adjacent-Segment Pathology After Single-Level Cervical Fusion.Medical science monitor : international medical journal of experimental and clinical research · 2017
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Itaru YuguéDepartment of Orthopaedic Surgery, Japan Labour Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, Japan. iyugue@orange.ocn.ne.jp.
Seiji OkadaDepartment of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
Muneaki MasudaDepartment of Orthopaedic Surgery, Japan Labour Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, Japan.
Takayoshi UetaDepartment of Orthopaedic Surgery, Japan Labour Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, Japan.
Takeshi MaedaDepartment of Orthopaedic Surgery, Japan Labour Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, Japan.
Keiichiro ShibaDepartment of Orthopaedic Surgery, Japan Labour Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe determined the incidence of and risk factors for clinical adjacent segment pathology (C-ASP) requiring additional surgeries among patients previously treated with one-segment lumbar decompression and fusion surgery.

methodsWe retrospectively analysed 161 consecutive patients who underwent one-segment lumbar decompression and fusion surgery for L4 degenerative spondylolisthesis. Patient age, sex, body mass index (BMI), facet orientation and tropism, laminar inclination angle, spinal canal stenosis ratio [on myelography and magnetic resonance imaging (MRI)], preoperative adjacent segment instability, arthrodesis type, pseudarthrosis, segmental lordosis at L4-5, and the present L4 slip were evaluated by a log-rank test using the Kaplan-Meier method. A multivariate Cox proportional-hazards model was used to analyse all factors found significant by the log-rank test.

resultsOf 161 patients, 22 patients (13.7 %) had additional surgeries at cranial segments located adjacent to the index surgery's location. Pre-existing canal stenosis ≥47 % at the adjacent segment on myelography, greater facet tropism, and high BMI were significant risk factors for C-ASP. The estimated incidences at 10 years postoperatively for each of these factors were 51.3, 39.6, and 32.5 %, and the risks for C-ASP were 4.9, 3.7, and, 3.1 times higher than their counterparts, respectively. Notably, spinal canal stenosis on myelography, but not on MRI, was found to be a significant risk factor for C-ASP (log-rank test P < 0.0001 and 0.299, respectively).

conclusionsPre-existing spinal stenosis, greater facet tropism, and higher BMI significantly increased C-ASP risk. Myelography is a more accurate method for detecting latent spinal canal stenosis as a risk factor for C-ASP.

Indexed as

Decompression, SurgicalSpinal FusionAdultAgedAged, 80 and overBody Mass IndexFemaleHumansLumbar VertebraeMagnetic Resonance ImagingMaleMiddle AgedMyelographyPreoperative PeriodProportional Hazards ModelsRetrospective StudiesAdjacent segment pathologyBody mass indexDegenerative spondylolisthesisFacet tropismPre-existing spinal stenosis

Identifiers

PMID26272373

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.