Evidence map›Paper›PMID 40699269›Full record

SynthesisSpine deformity2025

Does postoperative shoulder imbalance affect patient reported functional outcomes after posterior surgical correction of adolescent idiopathic scoliosis? A systematic review and meta-analysis.

Alan Maximiliano Gessara, Siddharth Shah, Mostafa ELMeshneb, Akshay Gadiya, Masood Shafafy, Michael Grevitt, Shakil Mohammed Patel

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

7 authors.

Alan Maximiliano GessaraUniversity Hospitals of Leicester NHS Trust, Leicester, UK. alan.gessara@gmail.com.ORCID http://orcid.org/0000-0003-2211-6162
Siddharth ShahNottingham University Hospitals NHS Trust, Nottingham, UK.
Mostafa ELMeshnebNottingham University Hospitals NHS Trust, Nottingham, UK.
Akshay GadiyaNottingham University Hospitals NHS Trust, Nottingham, UK.
Masood ShafafyNottingham University Hospitals NHS Trust, Nottingham, UK.
Michael GrevittNottingham University Hospitals NHS Trust, Nottingham, UK.
Shakil Mohammed PatelNottingham University Hospitals NHS Trust, Nottingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFailure to balance the shoulders whilst surgically correcting AIS has been reported in many publications as being associated with negative PROMS. However, the evidence to support this, in our opinion, is limited. The purpose of this study was to systematically review the literature and perform a meta-analysis to identify whether postoperative shoulder imbalance affects patient reported outcome measures.

methodsA systematic review and meta-analysis was conducted on the available literature comparing clinical and/or radiographic features of postoperative shoulder imbalance following surgery for AIS with patient reported outcome measures.

resultsThirteen studies with 924 patients were included. The mean follow-up was 3.7 years (2-16). The incidence of radiographic PSI was 30.1% and clinical PSI was 22.7%. A mix of validated (most commonly used SRS-22) and nonvalidated PROMs were used. Studies using radiographic PSI assessment showed no difference in PROMs for most validated scores. Clinical assessment studies showed that patients with even shoulders were also unsatisfied with their appearance. Meta-analysis of the extractable and analysable data showed no significant difference in PSI vs No-PSI in SRS-22.

conclusionContrary to popular belief, the findings of this systematic review and meta-analysis demonstrate that PSI is not associated with negative PROM using validated outcome measures.

Indexed as

Patient Reported Outcome MeasuresPostoperative ComplicationsScoliosisShoulderSpinal FusionAdolescentHumansTreatment OutcomeAdolescent idiopathic scoliosisClinical assessmentDeformity correctionPatient reported outcomesRadiological assessmentShoulder balance

Identifiers

PMID40699269

What OpenQuestion holds

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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.