Evidence map›Paper›PMID 39668262›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Long-term reoperation risk of thoracic to pelvis instrumentation for spinal deformity: a longitudinal study of 7,062 patients.

Paal K Nilssen, Nakul Narendran, David L Skaggs, Corey T Walker, Christopher M Mikhail, Edward Nomoto, Alexander Tuchman

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Article in 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. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Trial
  2. Surgical planning for spinal deformity correction: the contribution of patient-specific rods.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
  3. 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.

Paal K NilssenDepartment of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Nakul NarendranDepartment of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
David L SkaggsDepartment of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Corey T WalkerDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Christopher M MikhailDepartment of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Edward NomotoDepartment of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Alexander TuchmanDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. alexander.tuchman@cshs.org.ORCID 0000-0001-8419-3134

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo perform a large-scale assessment of reoperation risk among spine deformity patients undergoing thoracic to pelvis surgery.

methodsThe PearlDiver database was queried for spinal deformity patients (scoliosis, kyphosis, spondylolisthesis, sagittal plane deformity) undergoing at minimum, a T12-pelvis operation (2010-2020). CPT codes identified lumbar arthrodesis procedures that included pelvic fixation and ≥ 7 levels of posterior instrumentation on the same day. Minimum follow-up was 2 years. Reoperations included subsequent arthrodesis, decompression, osteotomy, device insertion, and pelvic fixation procedures. Multivariable regression analysis described associations between variables and reoperation risk.

results7,062 patients met criteria. Overall reoperation rate was 23.2%. Reoperation rate at 2- and 5-year was 16.9% and 22.1% respectively. 10-year reoperation-free probability was 73.7% (95% CI: 72.4-74.9%). Multivariable analysis revealed higher reoperation risk for patients with kyphosis and ≥ 13 levels of posterior instrumentation. Patients who received interbody cages had a lower reoperation risk. No association was found between the presence or absence of osteotomy procedures and reoperation risk. Lastly, linear regression analyses revealed no significant relationship between age or ECI and risk for subsequent operations did not independently influence reoperation.

conclusionsThis study, representing a real-world cohort of over six times the largest current prospective data set, found a 2-year reoperation rate of 17%, similar to previous studies, suggesting study group findings are applicable to a broader population. Preoperative kyphosis and ≥ 13 levels of posterior instrumentation was associated with higher reoperation risk, while the use of interbody cages was protective. Age, medical comorbidities, and osteotomies did not predict reoperations.

Indexed as

PelvisReoperationSpinal CurvaturesSpinal FusionThoracic VertebraeAdultAgedFemaleHumansKyphosisLongitudinal StudiesMaleMiddle AgedOsteotomyRisk FactorsComplicationInterbodyKyphosisReoperationSpine deformity;

Identifiers

PMID39668262

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.