Evidence map›Paper›PMID 41498956›Full record

SynthesisNeurosurgical review2026

Risk factors for cage subsidence in patients undergoing cervical fusion: a systematic review and meta-analysis.

Mingjiang Luo, Wanqing Xia, Lingling Jiang, Yanan Cai, Zirui Lan, Zhihong Xiao

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 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. 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.

Mingjiang LuoDepartment of Spine Surgery, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui People's Hospital, Lishui, China.
Wanqing XiaDepartment of Spine Surgery, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui People's Hospital, Lishui, China.
Lingling JiangDepartment of Spine Surgery, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui People's Hospital, Lishui, China.
Yanan CaiHengyang Medical School, University of South China, Hengyang City, Hunan Province, China.
Zirui LanHengyang Medical School, University of South China, Hengyang City, Hunan Province, China.
Zhihong XiaoDepartment of Spine Surgery, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui People's Hospital, Lishui, China. 35042875@qq.com.

Funding

Health and Family Planning Commission Program of Hunan Province 202204074707Health and Family Planning Commission Program of Wuhan City WX18C29
6 · The paper itself

Abstract

We conducted a systematic search of the literature in PubMed, EMBASE and the Cochrane Library until February 27, 2024. We also performed a manual search, including screening reference lists of previous systematic reviews and meta-analyses, to retrieve additional relevant articles for analysis. A random effects model was used to estimate pooled effects. On the basis of sample size, the P value of the Egger test, and interstudy heterogeneity, observational study evidence was classified as high quality (class I), medium quality (class II or III), or low quality (class IV). Sensitivity analyses also assessed the susceptibility of the findings of this meta-analysis. Of the 2,200 articles screened, 38 unique cohort studies comprising 3,736 patients were included in the data synthesis. Studies with high-quality evidence showed that male patients (OR, 1.30; 95% CI, 1.00 ~ 1.70) were at greater risk for cage subsidence. Studies with moderate-quality evidence suggested that patients with TMC without end-caps (OR 2.77; 95% CI, 1.25 ~ 6.16) were at greater risk for cage subsidence. Studies with low-quality evidence revealed that two-level surgery (OR, 1.72; 95% CI, 1.05 ~ 2.82), three-level surgery (OR, 1.96; 95% CI, 1.01 ~ 3.79), and multiple-level surgery (OR, 1.83; 95% CI, 1.17 ~ 2.85) were high risk factors for cage subsidence after cervical fusion. The meta-analysis revealed no associations between tobacco use, diabetes, cage type, or specific segment of surgery and cage subsidence. Our meta-analysis revealed significant risk factors for cage subsidence, including 1 patient-related risk factor (male) and 4 surgery-related risk factors (including TMC without end-caps and two-level, three-level, and multi-level surgeries). However, these findings must be interpreted with caution, as most risk factors in the study population were rare. Nevertheless, the findings may help clinicians identify high-risk patients to improve outcomes.

Indexed as

Cervical VertebraePostoperative ComplicationsSpinal FusionHumansMaleRisk FactorsCage subsidenceCervical fusionCohort studiesMeta-analysisRisk factors

Identifiers

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.