SynthesisNeurosurgical review2019
Pseudarthrosis in adult and pediatric spinal deformity surgery: a systematic review of the literature and meta-analysis of incidence, characteristics, and risk factors.
Synthesis in Neurosurgical review, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 5 of them syntheses that pooled 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.
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
53 citing papers in PubMed, 5 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- Local bone graft in adolescent idiopathic scoliosis surgery: a systematic review and meta-analysis.Spine deformity · 2026Pooled it
- Combined anterior-posterior versus posterior only approach for surgical management of adult spinal deformity: a systematic review and meta-analysis of comparative studies.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 · 2025Pooled it
- Pseudarthrosis risk factors in lumbar fusion: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2024Pooled it
- A systematic review and meta-analysis of fusion rate enhancements and bone graft options for spine surgery.Scientific reports · 2022Pooled it
- Titanium (Ti) cages may be superior to polyetheretherketone (PEEK) cages in lumbar interbody fusion: a systematic review and meta-analysis of clinical and radiological outcomes of spinal interbody fusions using Ti versus PEEK cages.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 · 2021Pooled it
- An Unexpected Journey: Migration of a Scoliosis Rod to the Groin.Acta orthopaedica et traumatologica turcica · 2026Article
- A bone graft substitute is effective for posterior spinal fusion in patients with juvenile or adolescent idiopathic scoliosis: a retrospective study.Journal of spine surgery (Hong Kong) · 2026Article
- The impact of bone graft volume on risk of pseudarthrosis, screw loosening, and rod breakage in surgical correction of adult spinal deformity.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
- Investigating the Relationship Between High Density Lipoprotein Cholesterol and Fusion Outcomes Following Single Level Lumbar Fusion: A Propensity Matched Analysis.Global spine journal · 2026Article
- Exploring the indications, failures, and treatment of complications after a C2 to pelvis fusion.Spine deformity · 2026Article
- One-year CT evaluation of fusion in adult spinal deformity using supplemental anterior lumbar interbody fusion.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
- Adult degenerative scoliosis: challenges in diagnosis, pain management, and surgical decision-making.Frontiers in surgery · 2026Review
- Efficacy of Modified Transforaminal Lumbar Interbody Fusion in Three-Planar Correction for Severe Adult Spinal Deformity: Radiographic and Clinical Outcomes.Orthopedic research and reviews · 2026Article
- Pseudoarthrosis after thoracolumbar fusion in patients with Parkinson's disease.Journal of spine surgery (Hong Kong) · 2025Article
- Clinical and Sociodemographic Characterization of Mexican Cohort with Pseudoarthrosis: A Retrospective, Cross-Sectional, and Descriptive Study.Reports (MDPI) · 2025Article
- The Application of Biologic and Synthetic Bone Grafts in Scoliosis Surgery: A Scoping Review of Emerging Technologies.Healthcare (Basel, Switzerland) · 2025Review
- Spinoplastic Surgery: A Review of Techniques, Indications, and Optimal Patient Selection.Brain sciences · 2025Review
- Developing a risk score to inform the use of rhBMP-2 in adult spinal deformity surgery.Spine deformity · 2025Article
- Characterization of Patients with Poor Clinical Outcome after Adult Spinal Deformity Surgery: A Multivariate Analysis of Mean 8-Year Follow-Up Data.Journal of clinical medicine · 2024Article
- Surgery for spinal deformity with osteoporosis: Achieving successful fusion.Osteoporosis and sarcopenia · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
We conducted a systematic review with meta-analysis and qualitative synthesis. This study aims to characterize pseudarthrosis after long-segment fusion in spinal deformity by identifying incidence rates by etiology, risk factors for its development, and common features. Pseudarthrosis can be a painful and debilitating complication of spinal fusion that may require reoperation. It is poorly characterized in the setting of spinal deformity. The MEDLINE, EMBASE, and Cochrane databases were searched for clinical research including spinal deformity patients treated with long-segment fusions reporting pseudarthrosis as a complication. Meta-analysis was performed on etiologic subsets of the studies to calculate incidence rates for pseudarthrosis. Qualitative synthesis was performed to identify characteristics of and risk factors for pseudarthrosis. The review found 162 articles reporting outcomes for 16,938 patients which met inclusion criteria. In general, the included studies were of medium to low quality according to recommended reporting standards and study design. Meta-analysis calculated an incidence of 1.4% (95% CI 0.9-1.8%) for pseudarthrosis in adolescent idiopathic scoliosis, 2.2% (95% CI 1.3-3.2%) in neuromuscular scoliosis, and 6.3% (95% CI 4.3-8.2%) in adult spinal deformity. Risk factors for pseudarthrosis include age over 55, construct length greater than 12 segments, smoking, thoracolumbar kyphosis greater than 20°, and fusion to the sacrum. Choice of graft material, pre-operative coronal alignment, post-operative analgesics, and sex have no significant impact on fusion rates. Older patients with greater deformity requiring more extensive instrumentation are at higher risk for pseudarthrosis. Overall incidence of pseudarthrosis requiring reoperation is low in adult populations and very low in adolescent populations.
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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.