Evidence map›Paper›PMID 41490721›Full record

ArticleAsian spine journal2026

Impact of abscess type on outcomes following posterior fixation for thoracolumbar pyogenic spondylitis: a multicenter retrospective cohort study.

Hisanori Gamada, Toru Funayama, Yosuke Ogata, Takane Nakagawa, Takahiro Sunami, Kotaro Sakashita, Shun Okuwaki, Kento Inomata, Kaishi Ogawa, Yosuke Shibao and 8 more

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Article in Asian spine journal, 2026. 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

18 authors.

Hisanori GamadaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan. hisanorigamada@gmail.com.
Toru FunayamaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Yosuke OgataDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Takane NakagawaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Takahiro SunamiDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Kotaro SakashitaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Shun OkuwakiDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital, Mito Clinical Education and Training Center/Mito Kyodo General Hospital, Mito, Japan.
Kento InomataDepartment of Orthopaedic Surgery, Kenpoku Medical Center/Takahagi Kyodo Hospital, Takahagi, Japan.
Kaishi OgawaDepartment of Orthopaedic Surgery, Showa General Hospital, Kodaira, Japan.
Yosuke ShibaoDepartment of Orthopaedic Surgery, Ibaraki Western Medical Center, Chikusei, Japan.
Hiroshi KumagaiDepartment of Orthopaedic Surgery, Ichihara Hospital, Tsukuba, Japan.
Katsuya NagashimaDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital, Mito Clinical Education and Training Center/Mito Kyodo General Hospital, Mito, Japan.
Kengo FujiiDepartment of Orthopaedic Surgery, Showa General Hospital, Kodaira, Japan.
Yosuke TakeuchiDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital, Mito Clinical Education and Training Center/Mito Kyodo General Hospital, Mito, Japan.
Masaki TatsumuraDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital, Mito Clinical Education and Training Center/Mito Kyodo General Hospital, Mito, Japan.
Itsuo ShiinaDepartment of Orthopaedic Surgery, Moriya Daiichi General Hospital, Moriya, Japan.
Masafumi UesugiDepartment of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital, Sashima, Japan.
Masao KodaDepartment of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designMulticenter retrospective cohort study. PURPOSE: To evaluate the impact of abscess presence and type on treatment duration and clinical outcomes in patients undergoing minimally invasive posterior fixation for thoracolumbar pyogenic spondylitis. OVERVIEW OF LITERATURE: Surgical management is increasingly favored for pyogenic spondylitis. Abscesses, particularly epidural and iliopsoas, have been linked to poorer prognoses, and empyema, though uncommon, tends to be particularly severe. However, the effect of specific abscess types on surgical outcomes remains unclear.

methodsThis study included 92 patients who underwent minimally invasive posterior fixation across 10 centers between 2014 and 2024. Patients were classified into an abscess group (epidural, iliopsoas, empyema, or other) and a non-abscess group. Clinical outcomes, including total duration of intravenous antibiotics and unplanned additional surgeries, were compared. Subgroup and regression analyses were conducted to assess the impact of specific abscess type.

resultsAbscesses were present in 65 patients (71%): epidural (n=51), iliopsoas (n=38), and empyema (n=3), with some overlap. Compared with the non-abscess group (n=27; 29%), there were no significant differences in antibiotic duration or rates of unplanned additional surgery. However, iliopsoas abscess was associated with longer antibiotic duration (8.1 weeks vs. 6.6 weeks, p =0.044), while all empyema cases required additional surgery for poor infection control (p =0.000). Regression analysis identified iliopsoas abscess and age ≥65 years as independent predictors of prolonged antibiotic use, whereas epidural abscess was associated with shorter antibiotic duration.

conclusionsIliopsoas abscesses were associated with longer antibiotic courses, while empyema was linked to poor infection control and a higher likelihood of additional surgery.

Indexed as

AbscessMinimally invasive surgical proceduresMulticenter studyPosterior fixationPyogenic spondylitis

Identifiers

PMID41490721
PMCPMC13329231

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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.