Evidence map›Paper›PMID 40064685›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

Early revision rate after posterior spinal fusion surgery increases with every additional BMI point.

Alexander Hammer, Achim Götz, Denis Rappert, Olga Cheremina, Thomas Eibl, Thomas Tischer, Björn Lembcke, Klaus John Schnake

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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. Review
  2. Not just alignment: body shape influences adult spinal deformity biomechanics.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. 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.

Alexander HammerCenter for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, 90451, Erlangen, Germany. alexander.hammer@waldkrankenhaus.de.
Achim GötzCenter for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, 90451, Erlangen, Germany.
Denis RappertCenter for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, 90451, Erlangen, Germany.
Olga ChereminaCenter for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, 90451, Erlangen, Germany.
Thomas EiblDepartment of Neurosurgery, Paracelsus Medical University, Breslauer Straße 201, 90471, Nuremberg, Germany.
Thomas TischerDepartment of Orthopedic Surgery, University Medical Centre Rostock, Doberaner Straße 142, 18057, Rostock, Germany.
Björn LembckeDepartment of Orthopedic Surgery, University Medical Centre Rostock, Doberaner Straße 142, 18057, Rostock, Germany.
Klaus John SchnakeCenter for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, 90451, Erlangen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRevision surgery has a profound impact on patient outcomes and is a crucial consideration in the assessment of healthcare burden following spine surgery. In this context, obesity is a significant factor influencing the rate of revision surgery. To elucidate the impact of obesity on the risk of early revision surgery after posterior fusion of the thoracic and lumbar spine, we conducted a prospective single-institution cohort study.

methodsOver a 24-month period a total of 227 consecutive patients who underwent posterior thoracolumbar spinal fusion surgery involving up to four segments were included in the analysis. The objective was to identify factors associated with early revision surgery occurring within three months. The impact of demographic data, comorbidities, intraoperative variables, and follow-up data on the incidence of revision surgery were evaluated through univariate and multivariate statistical analysis. The revision rate was examined according to body mass index (BMI) subcategories. Receiver operating characteristic (ROC) curves were generated using the variables BMI and revision surgery, as well as their respective subcategories (hematoma, infection, implant dislocation, and dural tear).

resultsUnivariate analysis demonstrated that obesity (25.3% BMI ≥ 30 vs. 10.9% BMI < 30, p = 0.005), ASA-grade (12.4% ASA grade 1 and 2 vs. 24.4% ASA grade ≥ 3, p = 0.019), and increased intraoperative blood loss (474.1 ml ± 275.3 ml vs. 587.2 ml ± 310.5 ml, p = 0.026) were statistically significant factors associated with increased revision rates. However, logistic binary regression analysis revealed that increasing BMI was the only significant independent variable (OR 1.10; 95% CI 1.02-1.19; p = 0.01). The total revision rate was 17.2% and increased significantly from 5.7% in patients with normal weight to 31.0% in extremely obese patients (BMI ≥ 35 kg/m

conclusionObesity is associated with an increased likelihood of requiring early revision surgery following posterior thoracolumbar spinal fusion procedures. The risk increases with each BMI point with the cutoff being around 29 kg/m

Indexed as

Body Mass IndexLumbar VertebraeObesityPostoperative ComplicationsReoperationSpinal FusionThoracic VertebraeAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesRisk FactorsBody mass indexObesityPosterior fusionRevision surgeryThoracolumbar

Identifiers

PMID40064685

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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.