Evidence map›Paper›PMID 41541235›Full record

ArticleNorth American Spine Society journal2026

Proton pump inhibitors are associated with increased risk of pseudoarthrosis after lumbar fusion.

Melissa Romoff, Michael S Kim, Courtney Spitzer, Andy Ton, Vivian Chen, Ryan Le, Abhinav Sharma, Emily Mills, Hao-Hua Wu, Don Young Park and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in North American Spine Society journal, 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

13 authors.

Melissa RomoffDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Michael S KimDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Courtney SpitzerDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Andy TonDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Vivian ChenDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Ryan LeDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Abhinav SharmaDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Emily MillsDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Hao-Hua WuDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Don Young ParkDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Yu-Po LeeDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Nitin BhatiaDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.
Sohaib HashmiDepartment of Orthopedic Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pseudoarthrosis is a major complication following lumbar spine fusion, leading to revision surgery, increased disability, and substantial economic burden. Proton pump inhibitors (PPIs) are commonly used in the perioperative period, but their impact on fusion success remains poorly defined. Methods: This retrospective cohort study utilized the TriNetX research database to identify adult patients undergoing lumbar spine fusion. Patients were divided into 2 cohorts based on documented PPI use within 30 days postoperatively and underwent 1:1 propensity score matching based on demographic and clinical characteristics. The incidence of pseudoarthrosis was assessed using diagnostic coding, and risk was compared using risk ratios and Kaplan-Meier survival analysis. An age-stratified analysis was also performed. Results: A total of 122,584 matched pairs were analyzed. Pseudoarthrosis occurred in 7.38% of PPI users compared to 3.98% of nonusers (RR: 1.88; p < .0001). Kaplan-Meier survival analysis revealed early separation of pseudoarthrosis-free survival curves by postoperative day 60, persisting through 1-year follow-up. Age-stratified analysis showed consistently higher pseudoarthrosis risk among PPI users across all age groups, with the largest relative impact observed in patients under 55 years old. Conclusions: Postoperative PPI use is associated with a significantly increased risk of pseudoarthrosis following lumbar spine fusion. These findings suggest careful consideration of the necessity of PPI therapy in the perioperative period, particularly in younger patients where the relative impact appears the greatest.

Indexed as

Bone healingLumbar fusionPostoperative complicationsProton pump inhibitorsPseudoarthrosisSpinal arthrodesis

Identifiers

PMID41541235
PMCPMC12800474

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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.