Evidence map›Paper›PMID 40249547›Full record

ArticleSpine deformity2025

Higher intraoperative blood loss is associated with increased risk of intraoperative neuromonitoring data loss for the type 3 spinal cord shape during spinal deformity surgery.

Chun Wai Hung, Fthimnir M Hassan, Nathan J Lee, Steven G Roth, Justin K Scheer, Erik Lewerenz, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke

Abstract read
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Article in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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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.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Chun Wai HungDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.
Fthimnir M HassanDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA. fh2444@cumc.columbia.edu.ORCID http://orcid.org/0000-0003-3928-8972
Nathan J LeeDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.
Steven G RothDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.
Justin K ScheerDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.
Erik LewerenzDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.
Joseph M LombardiDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.
Zeeshan M SardarDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.
Ronald A LehmanDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.
Lawrence G LenkeDepartment of Orthopaedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, 5141 Broadway, New York, NY, 10034, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess risk factors associated with an increased risk of intraoperative neuromonitoring (IONM) loss among spinal deformity patients with type 3 spinal cord (T3SC) shapes.

methodsThis is a retrospective cohort study of adult and pediatric patients with T3SC undergoing spinal deformity surgery from a single center between 2016 and 2023. The primary outcome examined was whether there was IONM data loss. Demographic, clinical, operative, and radiographic variables were compared between patients with and without IONM data loss.

resultsA total of 79 patients with T3SC were identified: 31 (39.2%) had IONM data loss, while 48 (60.8%) did not. There were no differences between the groups in terms of age, sex, or BMI (p > 0.05). There were no significant differences in the preoperative and postoperative coronal (C-DAR), sagittal (S-DAR), or total deformity angle ratio (T-DAR) (p > 0.05). There was no difference in the proportion of patients with a VCR, or in the mean instrumented number of levels. There was no difference in measured cord deformation using the area of the spinal cord shape as well as the long- and short-axis dimensions on an axial MRI cut. However, there was a statistically significantly higher EBL (1320.7 ± 614.0 vs. 1049.0 ± 468.4, p = 0.0316), TXA use (2619.8 ± 1333.1 cc vs. 1925.9 ± 1304.2, p = 0.0372), and cell saver salvage (468.5 ± 266.2 vs. 311.5 ± 266.2, p = 0.0264) in the IONM-Loss group.

conclusionIn this largest reported cohort patients with T3SC undergoing spinal deformity surgery, the only factors found to be significantly associated with an increased risk of IONM loss was higher EBL, higher autologous salvage transfused blood volume, and higher TXA given. It is critical for deformity surgeons to be aware of the importance of blood and hemodynamics management when treating this unique and high-risk population.

Indexed as

Blood Loss, SurgicalIntraoperative Neurophysiological MonitoringSpinal CordSpinal CurvaturesAdolescentAdultChildFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesRisk FactorsScoliosisYoung AdultIntraoperative neuromonitoringNeurological complicationsSpinal cord classificationSpinal deformity

Identifiers

PMID40249547

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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.