Evidence map›Paper›PMID 35199320›Full record

ArticleSpine deformity2022

Establishing consensus: determinants of high-risk and preventative strategies for neurological events in complex spinal deformity surgery.

Rajiv R Iyer, Michael G Vitale, Adam N Fano, Hiroko Matsumoto, Daniel J Sucato, Amer F Samdani, Justin S Smith, Munish C Gupta, Michael P Kelly, Han Jo Kim and 7 more

Abstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in Spine deformity, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.0field-weighted citation impact, top 15% 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.

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

6 citing papers in PubMed, 9 citations in OpenAlex.

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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

17 authors at 11 institutions in 2 countries.

Rajiv R IyerDivision of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Irving Medical Center, 3959 Broadway, CHONY 8-N, New York, NY, 10032-3784, USA.
Michael G VitaleDivision of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Irving Medical Center, 3959 Broadway, CHONY 8-N, New York, NY, 10032-3784, USA.
Adam N FanoDivision of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Irving Medical Center, 3959 Broadway, CHONY 8-N, New York, NY, 10032-3784, USA.
Hiroko MatsumotoDivision of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Irving Medical Center, 3959 Broadway, CHONY 8-N, New York, NY, 10032-3784, USA. hm2174@cumc.columbia.edu.ORCID 0000-0002-2270-7651
Daniel J SucatoDepartment of Orthopaedic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Amer F SamdaniShriners Hospitals for Children, Philadelphia, PA, USA.
Justin S SmithDepartment of Neurosurgery, University of Virginia Medical Center, Charlottesville, VA, USA.
Munish C GuptaDepartment of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Michael P KellyDepartment of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Han Jo KimHospital for Special Surgery, New York, NY, USA.
Daniel M SciubbaDepartment of Neurosurgery, Long Island Jewish Medical Center, North Shore University Hospital of Northwell Health, New York, NY, USA.
Samuel K ChoDepartment of Orthopedic Surgery, Mount Sinai Medical Center, New York, NY, USA.
David W PollyDepartment of Orthopedic Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Oheneba Boachie-AdjeiFOCOS Orthopedic Hospital, Patang, Accra, Ghana.
Peter D AngevineThe Daniel and Jane Och Spine Hospital at New York-Presbyterian/Allen, New York, NY, USA.
Stephen J LewisDivision of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada.
Lawrence G LenkeThe Daniel and Jane Och Spine Hospital at New York-Presbyterian/Allen, New York, NY, USA.
Morgan Stanley Children's Hospital · USColumbia University Irving Medical Center · USWashington University in St. Louis · USHospital for Special Surgery · USMount Sinai Medical Center · USNorthwell Health · USShriners Hospitals for Children - Philadelphia · USThe University of Texas Southwestern Medical Center · USUniversity of Minnesota Medical Center · USUniversity of Toronto · CAUniversity of Virginia Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo establish expert consensus on various parameters that constitute elevated risk during spinal deformity surgery and potential preventative strategies that may minimize the risk of intraoperative neuromonitoring (IONM) events and postoperative neurological deficits.

methodsThrough a series of surveys and a final virtual consensus meeting, the Delphi method was utilized to establish consensus among a group of expert spinal deformity surgeons. During iterative rounds of voting, participants were asked to express their agreement (strongly agree, agree, disagree, strongly disagree) to include items in a final set of guidelines. Consensus was defined as ≥ 80% agreement among participants. Near-consensus was ≥ 60% but < 80% agreement, equipoise was ≥ 20% but < 60%, and consensus to exclude was < 20%.

resultsFifteen of the 15 (100%) invited expert spinal deformity surgeons agreed to participate. There was consensus to include 22 determinants of high-risk (8 patient factors, 8 curve and spinal cord factors, and 6 surgical factors) and 21 preventative strategies (4 preoperative, 14 intraoperative, and 3 postoperative) in the final set of best practice guidelines.

conclusionA resource highlighting several salient clinical factors found in high-risk spinal deformity patients as well as strategies to prevent neurological events was successfully created through expert consensus. This is intended to serve as a reference for surgeons and other clinicians involved in the care of spinal deformity patients. LEVEL OF EVIDENCE: Level V.

Indexed as

Neurosurgical ProceduresSpineConsensusDelphi TechniqueHumansSurveys and QuestionnairesExpert consensusHigh-riskIntraoperative neuromonitoringNeurological deficitPreventionSpinal deformity

Identifiers

PMID35199320
OpenAlexW4213433885

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.