Evidence map›Paper›PMID 33906457›Full record

ArticleGlobal spine journal2023

Lowest Instrumented Vertebra Selection to S1 or Ilium Versus L4 or L5 in Adult Spinal Deformity: Factors for Consideration in 349 Patients With a Mean 46-Month Follow-Up.

Yu-Cheng Yao, Han Jo Kim, Mathieu Bannwarth, Justin Smith, Shay Bess, Eric Klineberg, Christopher P Ames, Christopher I Shaffrey, Douglas Burton, Munish Gupta and 4 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Global spine journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05566119 (L5-S1 Disc Fate in Thoracolumbar Arthrodesis Stopping at L5), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 21% of its field
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.

NCT05566119 unknown statusnot on this map

L5-S1 Disc Fate in Thoracolumbar Arthrodesis Stopping at L5

TypeobservationalSponsorFondation Hôpital Saint-JosephRan2022 to 2023Enrolled17ConditionsSpinal Deformity
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Limitations of fusion without pelvic foundation in adult spinal deformity 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
    Article
  3. Free-hand insertion of S2AI screw: what can we learn from O-arm navigation?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 · 2025
    Article
  4. Review
  5. Article
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 10 institutions in 3 countries.

Yu-Cheng YaoDepartment of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.ORCID 0000-0001-7555-4321
Han Jo KimSpine Service, Hospital for Special Surgery, New York, NY, USA.ORCID 0000-0003-2170-3592
Mathieu BannwarthNeurosurgery, University Hospital Reims, Reims, France.
Justin SmithDepartment of Neurosurgery, University of Virginia Health Sciences Center, Charlottesville, VA, USA.ORCID 0000-0003-0467-5534
Shay BessDepartment of Orthopaedic Surgery, Denver International Spine Center, Denver, CO, USA.
Eric KlinebergDepartment of Orthopaedic Surgery, University of California, Davis, Sacramento, CA, USA.
Christopher P AmesDepartment of Neurological Surgery, University of California, San Francisco, CA, USA.
Christopher I ShaffreyDepartment of Neurosurgery, University of Virginia Health Sciences Center, Charlottesville, VA, USA.
Douglas BurtonDepartment of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, KS, USA.
Munish GuptaDepartment of Orthopaedic Surgery, Washington University in St. Louis, MO, USA.ORCID 0000-0002-4711-4377
Gregory M MundisSan Diego Center for Spinal Disorders, La Jolla, CA, USA.
Richard HostinDepartment of Orthopaedic Surgery, Baylor Scoliosis Center, Plano, TX, USA.
Frank SchwabSpine Service, Hospital for Special Surgery, New York, NY, USA.
Virginie LafageSpine Service, Hospital for Special Surgery, New York, NY, USA.
Hospital for Special Surgery · USUniversity of Virginia · USBaylor University · USCentre Hospitalier Universitaire de Reims · FRSan Diego Center for Spinal Disorders · USTwin Cities Spine Center · USUniversity of California, Davis · USUniversity of California, San Francisco · USUniversity of Kansas Medical Center · USWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designRetrospective cohort study.

objectiveTo compare the outcomes of patients with adult spinal deformity (ASD) following spinal fusion with the lowest instrumented vertebra (LIV) at L4/L5 versus S1/ilium.

methodsA multicenter ASD database was evaluated. Patients were categorized into 2 groups based on LIV levels-groups L (fusion to L4/L5) and S (fusion to S1/ilium). Both groups were propensity matched by age and preoperative radiographic alignments. Patient demographics, operative details, radiographic parameters, revision rates, and health-related quality of life (HRQOL) scores were compared.

resultsOverall, 349 patients had complete data, with a mean follow-up of 46 months. Patients in group S (n = 311) were older and had larger sagittal and coronal plane deformities than those in group L (n = 38). After matching, 28 patients were allocated to each group with similar demographic, radiographic, and clinical parameters. Sagittal alignment restoration at postoperative week 6 was significantly better in group S than in group L, but it was similar in both groups at the 2-year follow-up. Fusion to S1/ilium involved a longer operating time, higher PJK rates, and greater PJK angles than that to L4/L5. There were no significant differences in the complication and revision rates between the groups. Both groups showed significant improvements in HRQOL scores.

conclusionsFusion to S1/ilium had better sagittal alignment restoration at postoperative week 6 and involved higher PJK rates and greater PJK angles than that to L4/L5. The clinical outcomes and rates of revision surgery and complications were similar between the groups.

Indexed as

adult spinal deformitycomplicationfusion ratehealth-related quality of life scoreslowest instrumented levelpropensity matchedproximal junctional kyphosis

Identifiers

PMID33906457
PMCPMC10189326
OpenAlexW3158683611

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.