Evidence map›Paper›PMID 36790587›Full record

SynthesisActa neurochirurgica2023

Removal or retention of minimally invasive screws in thoracolumbar fractures? Systematic review and case-control study.

Ravindran Visagan, Siobhan Kearney, Sebastian Trifoi, Nida Kalyal, Florence Hogg, Beatrice Quercetti, Mohamed Abdalla, Mihai Danciut, Marios C Papadopoulos

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.5field-weighted citation impact, top 11% 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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Review
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

9 authors at 2 institutions in 1 country.

Ravindran VisaganDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK.ORCID 0000-0002-2771-6434
Siobhan KearneyDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK.
Sebastian TrifoiDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK.
Nida KalyalDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK.
Florence HoggDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK.
Beatrice QuercettiDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK.
Mohamed AbdallaDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK.
Mihai DanciutDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK.
Marios C PapadopoulosDepartment of Neurosurgery, St. George's Hospital, Atkinson Morley Wing, London, SW17 0QT, UK. mpapadop@sgul.ac.uk.
Atkins (United Kingdom) · GBSt George's Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is uncertainty regarding delayed removal versus retention of minimally invasive screws following percutaneous fixation for thoracolumbar fractures. We conducted a systematic review and case-control study to test the hypothesis that delayed metalwork removal following percutaneous fixation for thoracolumbar fractures improves outcome.

methodsA systematic review was performed in accordance with the PRISMA guidelines. Our case-control study retrospectively evaluated 55 consecutive patients with thoracolumbar fractures who underwent percutaneous fixation in a single unit: 19 with metalwork retained (controls) and 36 with metalwork removed. Outcomes were the Oswestry Disability Index (ODI), a supplemental questionnaire, and complications.

resultsThe systematic review evaluated nine articles. Back pain was reduced in most patients after metalwork removal. One study found no difference in the ODI after versus before metalwork removal, whereas three studies reported significant improvement. Six studies noted no significant alterations in radiological markers of stability after metalwork removal. Mean complication rate was 1.7% (0-6.7). Complications were superficial wound infection, screw breakage at the time of removal, pull-out screw, and a broken rod. In the case-control study, both groups were well matched. For metalwork removal, mean operative time was 69.5 min (range 30-120) and length of stay was 1.3 days (0-4). After metalwork removal, 24 (68.6%) patients felt better, 10 (28.6%) the same and one felt worse. Two patients had superficial hematomas, one had a superficial wound infection, and none required re-operation. Metalwork removal was a significant predictor of return to work or baseline household duties (odds ratio 5.0 [1.4-18.9]). The ODI was not different between groups.

conclusionsThe findings of both the systematic review and our case-control study suggest that removal of metalwork following percutaneous fixation of thoracolumbar fractures is safe and is associated with improved outcome in most patients.

Indexed as

Fractures, BonePedicle ScrewsSpinal FracturesCase-Control StudiesFracture Fixation, InternalHumansLumbar VertebraeRetrospective StudiesThoracic VertebraeTreatment OutcomeFixationOutcomePedicle screwSpinal fracture

Identifiers

PMID36790587
PMCPMC10068661
OpenAlexW4320857376

What OpenQuestion holds

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LicenceCC BY
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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.