SynthesisSpine deformity2026
Association between lumbar lordosis and proximal junctional failure following adult spinal deformity surgery: a systematic review and meta-analysis.
Synthesis in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionProximal junctional failure (PJF) remains a challenging complication following instrumented posterior fusion for adult spinal deformity (ASD). Although radiographic parameters such as lumbar lordosis (LL) and pelvic incidence-lumbar lordosis mismatch (PI-LL) are frequently cited, their specific association with PJF risk is not fully defined. This systematic review and meta-analysis aimed to clarify whether postoperative LL, changes in LL (ΔLL), postoperative PI-LL, or changes in PI-LL (ΔPI-LL) are predictive of PJF in ASD.
methodsFollowing PRISMA 2020 and Cochrane guidelines, a comprehensive search of PubMed, Embase, Scopus, and Web of Science was conducted through August 2025. Eligible studies included adult cohorts undergoing instrumented fusion for ASD with extractable data on alignment exposures and PJF outcomes. Two independent reviewers performed study selection, data extraction, and quality appraisal using the NIH assessment tool. Random-effects meta-analysis was performed with mean differences (MD) and 95% confidence intervals, with heterogeneity evaluated via I
resultsFrom 3449 records, seven retrospective cohorts comprising 710 patients met inclusion. PJF occurred in 123 patients (17.3%), while 587 remained event-free. Absolute postoperative LL did not differ significantly between groups (MD = 0.70, 95% CI - 2.02 to 3.42, p = 0.61). However, patients with PJF demonstrated greater ΔLL (MD = 4.24, 95% CI 0.19-8.28, p = 0.04). Postoperative PI-LL was also higher in the PJF group (MD = 4.25, 95% CI 0.46-8.05, p = 0.03). ΔPI-LL was not significantly associated (MD = - 0.44, 95% CI - 7.23 to 6.34, p = 0.90).
conclusionGreater ΔLL and residual postoperative PI-LL mismatch significantly correlate with PJF, while final LL alone does not. These findings highlight the importance of proportional, age-adjusted alignment strategies and cautious correction magnitude to reduce mechanical failure risk in ASD surgery.
Indexed as
Identifiers
41724921What OpenQuestion holds
Registered trials
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.