Evidence map›Paper›PMID 38216297›Full record

ArticleInternational journal of spine surgery2024

Systematic Review and Meta-Analysis of the Effect of Osteoporosis on Fusion Rates and Complications Following Surgery for Degenerative Cervical Spine Pathology.

Elizabeth A Lechtholz-Zey, Mina Ayad, Brandon S Gettleman, Emily S Mills, Hannah Shelby, Andy Ton, John J S Shin, Jeffrey C Wang, Raymond J Hah, Ram K Alluri

Abstract read
In one paragraph

Article in International journal of spine surgery, 2024. 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. Development and evaluation of a simple CT-based DXA triage score for osteoporosis in candidates for lumbar spine 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 · 2026
    Article
  2. Article
  3. C-VBQ and CT hounsfield units for DXA-defined low bone mass screening and their associations with bone turnover markers.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 · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Thiazide diuretic use is associated with fewer hardware complications after anterior cervical discectomy and fusion.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
  9. 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

10 authors.

Elizabeth A Lechtholz-ZeyDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.
Mina AyadDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.
Brandon S GettlemanDepartment of Orthopaedic Surgery, University of South Carolina School of Medicine, Columbia, SC, USA.
Emily S MillsDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.
Hannah ShelbyDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.
Andy TonDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA andyton@usc.edu.
John J S ShinDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.
Jeffrey C WangDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.
Raymond J HahDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.
Ram K AlluriDepartment of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs the elderly population grows, the increasing prevalence of osteoporosis presents a unique challenge for surgeons. Decreased bone strength and quality are associated with hardware failure and impaired bone healing, which may increase the rate of revision surgery and the development of complications. The purpose of this review is to determine the impact of osteoporosis on postoperative outcomes for patients with cervical degenerative disease or deformity.

methodsA systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Medical Subject Headings terms involving spine surgery for cervical degenerative disease and osteoporosis were performed. This review focused on radiographic outcomes, as well as surgical and medical complications.

resultsThere were 16 studies included in the degenerative group and 9 in the deformity group. Across degenerative studies, lower bone mineral density was associated with increased rates of cage subsidence in osteoporotic patients undergoing operative treatment for cervical degenerative disease. Most studies reported varied results on the relationship between osteoporosis and other outcomes such as revision and readmission rates, costs, and perioperative complications. Our meta-analysis suggests that osteoporotic patients carry a greater risk of reduced fusion rates at 6 months and 1 year postoperatively. With respect to cervical deformity correction, although individual complication rates were unchanged with osteoporosis, the collective risk of incurring any complication may be increased in patients with poor bone stock.

conclusionsOverall, the literature suggests that outcomes for osteoporotic patients after cervical spine surgery are multifactorial. Osteoporosis seems to be a significant risk factor for developing cage subsidence and pseudarthrosis postoperatively, whereas reports on medical and hospital-related metrics were inconclusive. Our findings highlight the challenges of caring for osteoporotic patients and underline the need for adequately powered studies to understand how osteoporosis changes the risk index of patients undergoing cervical spine surgery. CLINICAL RELEVANCE: In patients undergoing cervical spine surgery for degenerative disease, osteoporosis is a significant risk factor for long-term postoperative complications-notably cage subsidence and pseudarthrosis. Given the elective nature of these procedures, interdisciplinary collaboration between providers should be routinely implemented to enable medical optimization of patients prior to cervical spine surgery. LEVEL OF EVIDENCE: 1:

Indexed as

cervicaldegenerativefusion

Identifiers

PMID38216297
PMCPMC11535765

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.