Evidence map›Paper›PMID 39714467›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

Risk factors for mortality after 3-column osteotomy.

Jake Carbone, Amit Ratanpal, Anthony K Chiu, Rohan I Suresh, Bradley Anderson, Bibhas Amatya, Amil Sahai, Brian Shear, Alexander Ruditsky, Sennay Ghenbot and 5 more

Abstract read
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In one paragraph

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 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Thoracic pedicle Subtraction osteotomies: a systematic review of indications, correction magnitudes, and safety profile.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
    Pooled it
  2. Article
  3. Article
  4. Ten-year follow-up report of corrective fusion with 3-column osteotomy in adult patients with spinal deformities: a retrospective case series.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
  5. Letter to the editor concerning "Risk factors for mortality after 3-column osteotomy" by Carbone J, et al. (Eur spine J [2024]: https://doi.org/10.1007/s00586-024-08616-9).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
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

15 authors.

Jake CarboneDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Amit RatanpalDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Anthony K ChiuDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Rohan I SureshDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Bradley AndersonDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Bibhas AmatyaDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Amil SahaiDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Brian ShearDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Alexander RuditskyDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Sennay GhenbotDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Louis J BivonaDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Julio J JaureguiDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Daniel L CavanaughDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Eugene Y KohDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA.
Steven C LudwigDivision of Spine Surgery, Department of Orthopaedics, University of Maryland Medical Center, 110 South Paca Street, Suite 300, Baltimore, MD, 21201, USA. umdorthospine@gmail.com.ORCID 0000-0002-3962-5724

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThree-column osteotomies (3COs), such as pedicle subtraction osteotomy (PSO) and vertebral column resection (VCR), are used to surgically correct rigid adult spinal deformity (ASD). While extensive research exists about complications associated with 3COs, there remains a paucity of studies analyzing risk factors for mortality following 3CO. We believe the mortality rate after 3-column osteotomy will be low with specific identifiable demographic or medical risk factors.

methodsA retrospective analysis was conducted using the National Surgical Quality Improvement Program (NSQIP) database. Patients undergoing 3CO were identified via CPT codes. The primary outcome of interest was 30-day postoperative mortality. Univariate statistical analysis was performed, followed by multivariable logistic regression controlling for age, sex, and body mass index (BMI).

resultsThe analysis included 1,441 patients. 446 patients had thoracic osteotomies, 996 patients had lumbar osteotomies, and 226 had multilevel osteotomies. The overall 30-day mortality rate was 1.2% (18 patients). On univariate analysis, mortality was more likely in patients with diabetes (2.8% vs. 1.2%, P = 0.029) and COPD (7.0% vs. 1.2%, P < 0.001). Mortality was associated with higher 5-factor modified frailty index (P = 0.004). After controlling for age, sex, and BMI, multivariable analysis revealed that mortality rates were independently associated with longer operative times (OR = 1.28, 95% CI:1.06-1.54, P = 0.010) and COPD (OR = 10.36, 95% CI: [2.17-49.47], P = 0.003).

conclusionThirty-day mortality after 3CO is 1.2% globally. The greatest univariate risk factors are diabetes, COPD, and frailty. Regardless of age, sex, or BMI, it was found that COPD and duration of surgery were independently associated with increased rates of mortality.

Indexed as

OsteotomyPostoperative ComplicationsAdultAgedFemaleHumansLumbar VertebraeMaleMiddle AgedRetrospective StudiesRisk FactorsThoracic Vertebrae3 column osteotomy (3CO)Adult spinal deformity (ASD)MortalityPedicle subtraction osteotomy (PSO)Vertebral column resection (VCR)

Identifiers

PMID39714467

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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.