Evidence map›Paper›PMID 36881755›Full record

ArticleGlobal spine journal2024

The L3 Flexion Angle Predicts Failure of Non-Operative Management in Patients with Tandem Spondylolithesis.

Jonathan F Dalton, Mitchell S Fourman, Bryan Rynearson, Rick Wawrose, Landon Cluts, Jeremy D Shaw, Joon Y Lee

Abstract read
In one paragraph

Article in Global spine journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

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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. 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

7 authors.

Jonathan F DaltonDepartment of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.ORCID 0000-0002-7452-2712
Mitchell S FourmanPittsburgh Orthopaedic Spine Research Group (POSR), University of Pittsburgh Medical Center, Pittsburgh, PA, USA.ORCID 0000-0001-5886-546X
Bryan RynearsonDepartment of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Rick WawroseDepartment of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Landon ClutsDepartment of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.ORCID 0000-0001-6042-4380
Jeremy D ShawDepartment of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Joon Y LeeDepartment of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designRetrospective cohort study.

objectiveDetermine impact of standard/novel spinopelvic parameters on global sagittal imbalance, health-related quality of life (HRQoL) scores, and clinical outcomes in patients with multi-level, tandem degenerative spondylolisthesis (TDS).

methodsSingle institution analysis; 49 patients with TDS. Demographics, PROMIS and ODI scores collected. Radiographic measurements-sagittal vertical axis (SVA), pelvic incidence (PI), lumbar lordosis (LL), PI-LL mismatch, sagittal L3 flexion angle (L3FA) and L3 sagittal distance (L3SD). Stepwise linear multivariate regression performed using full length cassettes to identify demographic and radiographic factors predictive of aberrant SVA (≥5 cm). Receiver operative curve (ROC) analysis used to identify cutoffs for lumbar radiographic values independently predictive of SVA ≥5 cm. Univariate comparisons of patient demographics, (HRQoL) scores and surgical indication were performed around this cutoff using two-way Student's t-tests and Fisher's exact test for continuous and categorical variables, respectively.

resultsPatients with increased L3FA had worse ODI (P = .006) and increased rate of failing non-operative management (P = .02). L3FA (OR 1.4, 95% CI) independently predicted of SVA ≥5 cm (sensitivity and specifity of 93% and 92%). Patients with SVA ≥5 cm had lower LL (48.7 ± 19.5 vs 63.3 ± 6.9 mm,

conclusionsIncreased flexion of L3, which is easily measured by the novel lumbar parameter L3FA, predicts global sagittal imbalance in TDS patients. Increased L3FA is associated with worse performance on ODI, and failure of non-operative management in patients with TDS.

Indexed as

global sagittal imbalancehealth-related quality of lifespinespondylolisthesis

Identifiers

PMID36881755
PMCPMC11418704

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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.