Evidence map›Paper›PMID 40540114›Full record

ArticleSpine deformity2025

Rod options to outcomes: comparing sagittal correction in pediatric posterior spinal fusion by rod size and material.

Julia E Todderud, Hans K Nugraha, Michael P Kelly, Joshua Pahys, Suken Shah, Nicholas Fletcher, Peter O Newton, Daniel Sucato, Burt Yaszay, A Noelle Larson and 1 more

Abstract readMulticenter StudyComparative Study
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In one paragraph

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.

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. Article
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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

11 authors.

Julia E TodderudDepartment of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Hans K NugrahaDepartment of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Michael P KellyDivision of Orthopedics and Scoliosis, Rady Children's Hospital San-Diego, San Diego, CA, USA.
Joshua PahysDepartment of Orthopedic Surgery, Shriners Children's, Philadelphia, PA, USA.
Suken ShahDepartment of Orthopedics, Nemours Children's Hospital, Wilmington, DE, USA.
Nicholas FletcherDepartment of Orthopedic Surgery, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Peter O NewtonDivision of Orthopedics and Scoliosis, Rady Children's Hospital San-Diego, San Diego, CA, USA.
Daniel SucatoScottish Rite Center for Children, Center for Excellence in Spine, Dallas, TX, USA.
Burt YaszayDivision of Orthopedics and Sports Medicine, Seattle Children's Hospital, Seattle, WA, USA.
A Noelle LarsonDepartment of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. larson.noelle@mayo.edu.ORCID http://orcid.org/0000-0001-6542-6975
Harms Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOur study aims to evaluate the impact of rod diameter and material on sagittal plane correction and reoperation. We hypothesize larger diameter rods would improve the sagittal plane alignment without increasing complications or progression of proximal junctional kyphosis (PJK).

methodsData were reviewed from consecutive series of Lenke 1-4 AIS patients enrolled in a multicenter registry between 2010 and 2019 with minimum 2-year follow-up. Patients who underwent PSF with 5 common rod types (5.5 or 6.0 cobalt chrome, 5.5 stainless steel, 5.5 or 6.0 titanium rods) were evaluated. Other rod types/diameters were excluded from this study.

results1348 patients treated by 29 surgeons at 13 centers met inclusion criteria. 42 had 5.5 titanium rods (3%), 651 patients had 5.5 cobalt chrome (48%), 586 had 5.5 stainless steel (43%), 46 had 6.0 titanium (3%), and 23 had 6.0 cobalt chrome (2%). Preoperatively there was no difference in curve magnitude or flexibility. Patients that received stiffer rods were older and taller. At 2 years, the 5.5 stainless steel patients had the greatest major curve correction (62.5%) while 5.5 titanium patients had the lowest correction (54.2%) (whole cohort p < 0.001). At 2-year follow-up there was most improved T2-T12 kyphosis in the 6.0 titanium group (+ 6.5°), and least in the 5.5 titanium group (-3.2°) (p = 0.014). T5-T12 changes were greatest in the 6.0 titanium group (+ 3.9°) and lowest in the 5.5 titanium group (-6.7°) (p < 0.001). PJK increased most in the 5.5 titanium cohort (+ 4.0) and least in the 6.0 cobalt chrome cohort (+ 0.8) (p < 0.001). Complication rates were highest in the 5.5 stainless steel patients (12.6%) while rates of reoperations were highest in the 5.5 cobalt chrome cohort (n = 9, 1.4%).

conclusionIn this retrospective review of patients undergoing PSF with rods of varying size and materials, there was evidence of better restoration of T5-T12 kyphosis with stiffer/larger rods without increased risk of PJK progression.

Indexed as

ScoliosisSpinal FusionAdolescentChildFemaleFollow-Up StudiesHumansKyphosisMaleReoperationRetrospective StudiesStainless SteelTitaniumTreatment OutcomeStainless SteelTitanium5.56.0Rod diameterRod typeSagittal planeScoliosis

Identifiers

PMID40540114

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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.