Evidence map›Paper›PMID 41160127›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 Society2026

Crossing the cervicothoracic junction in multilevel posterior fixations for degenerative cervical disease: a Swedish registry-based study.

Victor Gabriel El-Hajj, Massimo Bottini, Bahridin Nuriddinov, Victor E Staartjes, Erik Edström, Adrian Elmi-Terander

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, 2026. 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. Impact of obesity on patient-reported outcome measures and complications following anterior cervical surgery for cervical spondylosis: A cohort study Of 7,993 patients.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
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

6 authors.

Victor Gabriel El-HajjDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. victor.gabriel.elhajj@ki.se.
Massimo BottiniMachine Intelligence in Clinical Neuroscience (MICN) Laboratory, Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
Bahridin NuriddinovDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Victor E StaartjesDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Erik EdströmDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Adrian Elmi-TeranderDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe decision to cross the cervicothoracic junction (CTJ) during multilevel posterior cervical fusion remains controversial. While constructs extending into the thoracic spine may enhance stability, they may also increase surgical complexity. The clinical relevance of these differences, particularly regarding patient-reported outcomes (PROMs), is still unclear. We hence aimed to determine whether extending fusion across the CTJ impacts PROMs and perioperative complication rates in a nationwide cohort.

methodsThis retrospective cohort study used prospectively collected data from the Swedish Spine Registry (Swespine). Adult patients who underwent multilevel posterior cervical fusion were divided into two groups: those ending at C7 and those extending beyond the CTJ. Baseline characteristics, surgical details, complication rates, and PROMs at 1- and 5-years were compared.

resultsBaseline characteristics were similar between groups (p ≥ 0.5). Perioperative complication and reoperation rates did not differ significantly between groups (p ≥ 0.5). Similarly, at both one- and five-years of follow-up, PROMs, including pain scores, disability indices, and satisfaction, were comparable (p ≥ 0.5). However, a significant difference was observed in terms of fine motor recovery, with patients whose constructs crossed the CTJ demonstrating a greater degree of improvement (p = 0.009).

conclusionsCrossing the CTJ in multilevel posterior cervical fusion does not significantly affect complication rates, reoperations, or most PROMs at one and five years. Surgical decisions should prioritize anatomical and clinical factors, rather than expected differences in PROMs.

Indexed as

ConstructCrossing the cervicothoracic junctionCTJMultilevel fixationPosterior fixation

Identifiers

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.