Evidence map›Paper›PMID 39960495›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

Iatrogenic posterior translation of the construct at the uppermost instrumented vertebrae is associated with proximal junctional kyphosis.

Bassel G Diebo, Mariah Balmaceno-Criss, Renaud Lafage, Manjot Singh, Mohammad Daher, D Kojo Hamilton, Justin S Smith, Robert K Eastlack, Richard Fessler, Jeffrey L Gum and 24 more

Abstract read
PubMed Publisher
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. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

34 authors.

Bassel G DieboDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, USA.
Mariah Balmaceno-CrissDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, USA.
Renaud LafageDepartment of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
Manjot SinghDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, USA.
Mohammad DaherDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, USA.
D Kojo HamiltonDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Justin S SmithDepartment of Neurosurgery, University of Virginia Medical Center, Charlottesville, VA, USA.
Robert K EastlackDivision of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA, USA.
Richard FesslerDepartment of Neurosurgery, Rush Medical College, Chicago, IL, USA.
Jeffrey L GumNorton Leatherman Spine Center, Louisville, KY, USA.
Munish C GuptaDepartment of Orthopedic Surgery, Washington University, St. Louis, MI, USA.
Richard HostinDepartment of Orthopedic Surgery, Southwest Scoliosis Center, Dallas, TX, USA.
Khaled M KebaishDepartment of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Han Jo KimHospital for Special Surger, New York, NY, USA.
Eric O KlinebergDepartment of Orthopedic Surgery, University of California-Davis, Davis, CA, USA.
Stephen LewisDepartment of Orthopedics, University of Toronto, Toronto, ON, Canada.
Breton G LineDepartment of Spine Surgery, Denver International Spine Center, Denver, CO, USA.
Pierce D NunleySpine Institute of Louisiana, Shreveport, LA, USA.
Gregory M MundisDivision of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA, USA.
Peter G PassiasDepartment of Orthopedics, NYU Langone Orthopedic Hospital, New York, NY, USA.
Themistocles S ProtopsaltisDepartment of Orthopedics, NYU Langone Orthopedic Hospital, New York, NY, USA.
Thomas BuellDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Justin K ScheerDepartment of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA.
Jeffery MullinDepartment of Neurosurgery, University of Buffalo, New York, NY, USA.
Alex SoroceanuDepartment of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada.
Christopher P AmesDepartment of Neurological Surgery, University of California, San Francisco, CA, USA.
Lawrence G LenkeDepartment of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA.
Shay BessDepartment of Spine Surgery, Denver International Spine Center, Denver, CO, USA.
Christopher I ShaffreyDepartment of Neurosurgery, Duke Spine Division, Durham, NC, USA.
Frank J SchwabDepartment of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
Douglas C BurtonDepartment of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, KS, USA.
Virginie LafageDepartment of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
Alan H DanielsDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, East Providence, RI, 02914, USA. alandanielsmd@gmail.com.ORCID 0000-0001-9597-4139
ISSG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine if iatrogenic posterior translation (UIV SPi) at the upper instrumented vertebrae (UIV) is associated with increased mechanical complications and secondarily to generate and validate a UIV SPi threshold for increased complications.

methodsTwo patient databases were utilized: one for generating a UIV SPi threshold and another for validation. Patients with a UIV between T8-L1 and a LIV at ilium were included. A receiver operating curve (ROC) curve analyses was performed to generate a threshold that predicted proximal junctional complications. This UIV SPi angle (-16.0°) was rounded to -15.0° for practical clinical use and validated in a separate cohort. Patients were stratified as above (most translated, MT) or below (least translated, LT) the threshold for comparative demographic and outcomes analyses.

resultsGeneration of the threshold on 192 patients (122 LT, 70 MT) revealed that the MT group had higher absolute postoperative UIV SVA (MT=-56.1 ± 23.1 mm vs. LT=-10.4 ± 31.8 mm, p < 0.001), higher PT (25.7° vs. 19.3°, p < 0.001), and 2.8-5.8 times greater odds of postoperative proximal junctional complications at 2-years (p < 0.05). Validation on 135 patients (95 LT, 40 MT) revealed that the MT group had 11.7 times greater odds of radiographic PJK and had 4.5 times greater odds of all-cause reoperations (p < 0.05).

conclusionPatients with UIV posterior translation, despite similar PI-LL and T1PA, exhibit a high PT and experience higher odds of proximal junctional complications. Our findings support limiting the UIV SPi to < 15° of posterior translation to mitigate postoperative mechanical complications. LEVEL OF EVIDENCE: IV.

Indexed as

Iatrogenic DiseaseKyphosisLumbar VertebraePostoperative ComplicationsSpinal FusionThoracic VertebraeAdultAgedFemaleHumansMaleMiddle AgedPosterior TranslationProximal Junctional KyphosisSpinal AlignmentSpinal overcorrectionUIV Spinopelvic InclinationUIV Translation

Identifiers

PMID39960495

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.