Evidence map›Paper›PMID 33993350›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 Society2021

Comparison of degenerative lumbar scoliosis correction and risk for mechanical failure using posterior 2-rod instrumentation versus 4-rod instrumentation and interbody fusion.

Vincent Lamas, Yann Philippe Charles, Nicolas Tuzin, Jean-Paul Steib

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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, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
  2. Development and validation of machine learning models for distal instrumentation-related problems in patients with degenerative lumbar scoliosis based on preoperative CT and MRI.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
  3. Influence of implant density on mechanical complications 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 · 2024
    Article
  4. Article
  5. Article
  6. Article
  7. Does the use of postoperative brace help preventing mechanical complications following adult 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 · 2023
    Article
  8. Article
  9. 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

4 authors.

Vincent LamasService de Chirurgie du Rachis, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle (FMTS), Université de Strasbourg, 1 Avenue Molière, 67200, Strasbourg, France. lamas.vincent@gmail.com.ORCID 0000-0003-0872-7151
Yann Philippe CharlesService de Chirurgie du Rachis, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle (FMTS), Université de Strasbourg, 1 Avenue Molière, 67200, Strasbourg, France.
Nicolas TuzinService de Santé Publique, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle (FMTS), Université de Strasbourg, Strasbourg, France.
Jean-Paul SteibService de Chirurgie du Rachis, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle (FMTS), Université de Strasbourg, 1 Avenue Molière, 67200, Strasbourg, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFour-rod instrumentation and interbody fusion may reduce mechanical complications in degenerative scoliosis surgery compared to 2-rod instrumentation. The purpose was to compare clinical results, sagittal alignment and mechanical complications with both techniques.

methodsFull spine radiographs were analysed in 97 patients instrumented to the pelvis: 58 2-rod constructs (2R) and 39 4-rod constructs (4R). Clinical scores (VAS, ODI, SRS-22, EQ-5D-3L) were assessed preoperatively, at 3 months, 1 year and last follow-up (average 4.2 years). Radiographic measurements were: thoracic kyphosis, lumbar lordosis, spinopelvic parameters, segmental lordosis distribution. The incidence of non-union and PJK were investigated.

resultsAll clinical scores improved significantly in both groups between preoperative and last follow-up. In the 2R-group, lumbar lordosis increased to 52.8° postoperatively and decreased to 47.0° at follow-up (p = 0.008). In the 4R-group, lumbar lordosis increased from 46.4 to 52.5° postoperatively and remained at 53.4° at follow-up. There were 8 (13.8%) PJK in the 2R-group versus 6 (15.4%) in the 4R-group, with a mismatch between lumbar apex and theoretic lumbar shape according to pelvic incidence. Non-union requiring revision surgery occurred on average at 26.9 months in 28 patients (48.3%) of the 2R-group. No rod fracture was diagnosed in the 4R-group.

conclusionMulti-level interbody fusion combined with 4-rod instrumentation decreased risk for non-union and revision surgery compared to select interbody fusion and 2-rod instrumentation. The role of additional rods on load sharing still needs to be determined when multiple cages are used. Despite revision surgery in the 2R group, final clinical outcomes were similar in both groups. LEVEL OF EVIDENCE: III.

Indexed as

KyphosisLordosisScoliosisSpinal FusionAnimalsHumansLumbar VertebraeRetrospective StudiesTreatment OutcomeAdult spinal deformityDegenerative scoliosisFour-rod instrumentationNon-unionProximal junctional kyphosisSagittal alignment

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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.