Evidence map›Paper›PMID 38546965›Full record

SynthesisSpine deformity2024

Comparable rates of lumbar disc degeneration at long-term following adolescent idiopathic scoliosis spinal fusion extended to L3 or L4: systematic review and meta-analysis.

Alberto Ruffilli, Matteo Traversari, Marco Manzetti, Giovanni Viroli, Elena Artioli, Simone Ottavio Zielli, Antonio Mazzotti, Cesare Faldini

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Spine deformity, 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

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. 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

8 authors.

Alberto RuffilliIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic -University of Bologna, Bologna, Italy.ORCID 0000-0002-4003-2387
Matteo TraversariIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic -University of Bologna, Bologna, Italy. Matteo.traversari@ior.it.ORCID 0000-0003-1524-1811
Marco ManzettiIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic -University of Bologna, Bologna, Italy.ORCID 0000-0003-3992-9637
Giovanni ViroliIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic -University of Bologna, Bologna, Italy.ORCID 0000-0003-4348-0983
Elena ArtioliIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic -University of Bologna, Bologna, Italy.ORCID 0000-0001-9279-4722
Simone Ottavio ZielliIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic -University of Bologna, Bologna, Italy.ORCID 0000-0003-0867-1338
Antonio MazzottiIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic -University of Bologna, Bologna, Italy.ORCID 0000-0001-9974-4787
Cesare FaldiniIRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology clinic -University of Bologna, Bologna, Italy.ORCID 0000-0002-0819-1935

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical treatment of adolescent idiopathic scoliosis (AIS) requires a careful choice of fusion levels. The usual recommendation for the selection of the lowest instrumented vertebra (LIV) for double major or thoracolumbar/lumbar (TL/L) curves falls on L3 or L4. The aim of the present study is to assess if the spinal fusion with LIV selection of L3 or L4 in AIS patients has a clinical or radiological impact in terms of degenerative disc disease (DDD) in distal unfused segments at long-term follow-up.

methodsA systematic search of electronic databases from eligible articles was conducted. Only studies regarding long-term follow-up of AIS patients treated with spinal fusion were included. Clinical and radiographic outcomes were extracted and summarized. Meta-analysis on long-term follow-up MRI studies was performed. p value < 0.05 was considered significant.

resultsFourteen studies were included, for a total of 1264 patients. Clinical assessment of included patients showed a slight tendency to have worse clinical outcomes if spinal fusion is extended to L4 rather than L3. Despite that, meta-analysis could not be performed on clinical parameters because of heterogeneity of evaluated PROMs in included studies. Magnetic resonance imaging (MRI) evaluation at long-term follow-up showed no significant difference in terms of disc degeneration rate at overall meta-analysis (p = 0.916) between patients fused to L3 and L4.

conclusionThe LIV selection of L3 rather than L4, according to current literature, does not prevent disc degeneration in distal unfused segments over the long term. Long-term studies of patients treated with contemporary spinal instrumentation are needed.

Indexed as

Intervertebral Disc DegenerationLumbar VertebraeScoliosisSpinal FusionAdolescentHumansMagnetic Resonance ImagingPostoperative ComplicationsTreatment OutcomeAdjacent segment diseaseAdolescent idiopathic scoliosisDegenerative disc diseaseLIVPedicle screwSpinal fusion

Identifiers

PMID38546965
PMCPMC11217089

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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.