Evidence map›Paper›PMID 36773216›Full record

ArticleSpine deformity2023

Incidence, etiology and time course of delays to adult spinal deformity surgery: a single-center experience.

Lisa DePledge, Philip K Louie, Cari E Drolet, Jesse Shen, Venu M Nemani, Jean-Christophe A Leveque, Rajiv K Sethi

Abstract read
In one paragraph

Article in Spine deformity, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. 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 · 2025
    Pooled it
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

7 authors.

Lisa DePledgeCenter for Neurosciences and Spine, Department of Neurosurgery, Virginia Mason Franciscan Health, Seattle, WA, USA.
Philip K LouieCenter for Neurosciences and Spine, Department of Neurosurgery, Virginia Mason Franciscan Health, Seattle, WA, USA. Louie.philip@gmail.com.ORCID http://orcid.org/0000-0002-4787-1538
Cari E DroletCenter for Neurosciences and Spine, Department of Neurosurgery, Virginia Mason Franciscan Health, Seattle, WA, USA.
Jesse ShenCenter for Neurosciences and Spine, Department of Neurosurgery, Virginia Mason Franciscan Health, Seattle, WA, USA.
Venu M NemaniCenter for Neurosciences and Spine, Department of Neurosurgery, Virginia Mason Franciscan Health, Seattle, WA, USA.
Jean-Christophe A LevequeCenter for Neurosciences and Spine, Department of Neurosurgery, Virginia Mason Franciscan Health, Seattle, WA, USA.
Rajiv K SethiCenter for Neurosciences and Spine, Department of Neurosurgery, Virginia Mason Franciscan Health, Seattle, WA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe sought to determine the incidence, origin, and timeframe of delays to adult spinal deformity surgery so that institutions using preoperative multidisciplinary patient assessment teams might better anticipate and address these potential delays.

methodsComplex spine procedures for treatment of adult spinal deformity from 1/1/18 to 8/31/21 were identified. Procedures for infection, tumor, and urgent/emergent cases were excluded. Operations delayed due to COVID or those that were performed outside of our established perioperative care pathway were also excluded. The electronic health record was used to identify the etiology and timeline of all pre- and peri-operative delays.

resultsOf 235 patients scheduled for complex spine surgery, 193 met criteria for inclusion. Of these patients, 35 patients experienced a surgical delay (18.1%) with a total of 41 delays recorded. Reasons for delay include medically unoptimized (25.6%), intraoperative complication (17.9%), patient directed delay (17.9%), patient illness/injury (15.4%), scheduling complication (10.3%), insurance delay/denial (5.1%), and unknown (2.6%). Twenty-four delays experienced by 22 individuals occurred within 7 days of their scheduled surgery date.

conclusionAt a single multidisciplinary center, most delays to adult spinal deformity surgery occur before a patient is admitted to the hospital, and for recommendations of additional medical workup/clearance. We suspect that the preoperative protocol might increase pre-admission delays for unoptimized patients, as the protocol is intended to ensure patients receive surgery only when they are medically ready. Further research is needed to determine the economic and system impact of delays related to a preoperative optimization protocol weighed against the reduction in adverse events these protocols can provide.

Indexed as

Postoperative ComplicationsSpineAdultCOVID-19HumansIncidenceOrthopedic ProceduresAdult spinal deformityCancellationsDelaysMultidisciplinary conference

Identifiers

PMID36773216
PMCPMC9918809

What OpenQuestion holds

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Registered trials

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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.