ArticleBMC musculoskeletal disorders2026
Posterior L5-S1 fusion with complete reduction for pediatric high-grade dysplastic spondylolisthesis: a multicenter retrospective case series with exploratory analysis of residual sagittal imbalance.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
background contextHigh-grade dysplastic spondylolisthesis (HGDS) is a rare pediatric spinal deformity characterized by severe lumbosacral dysplasia and sagittal malalignment. The optimal surgical strategy for achieving deformity correction while minimizing neurological risk remains controversial. PURPOSE: To evaluate radiographic and clinical outcomes of sacral dome osteotomy combined with complete L5 reduction and single-level posterior L5–S1 fusion in pediatric patients with HGDS, and to explore factors associated with residual postoperative sagittal imbalance. STUDY
designA multicenter retrospective case-series study. PATIENT SAMPLE: Thirty-one patients (30 females, 1 male; mean age 9.66 ± 2.27 years) with L5 high-grade dysplastic spondylolisthesis who underwent sacral dome osteotomy, complete L5 reduction, and posterior L5–S1 single-level fusion between 2008 and 2023. OUTCOME MEASURES: The primary outcome was residual sagittal imbalance at the latest follow-up, defined as sagittal vertical axis (SVA) > 5.0 cm or pelvic tilt to sacral slope ratio (PT/SS) > 1. These criteria represented global and regional malalignment, respectively.
methodsClinical and radiographic data were retrospectively reviewed. Patients were categorized according to the presence of residual sagittal imbalance at the final follow-up. Univariable and multivariable logistic regression analyses were performed in an exploratory manner to examine associations between selected clinical and radiographic variables and residual sagittal imbalance. Receiver operating characteristic (ROC) curve analysis was conducted to assess the discriminatory ability of preoperative sagittal vertical axis within this cohort.
resultsMean follow-up was 3.05 ± 2.01 years. Slip percentage improved from 61.0 ± 11.0 preoperatively to 13.0 ± 10.0 postoperatively (p < 0.001) and remained stable at 9.0 ± 12.0 at the latest follow-up. Lumbosacral and global sagittal alignment parameters demonstrated significant correction that was largely maintained over time. Seven patients (22.6%) demonstrated residual sagittal imbalance (SVA > 5.0 cm or PT/SS > 1). Greater preoperative SVA values were associated with residual postoperative sagittal imbalance (OR 1.04, 95% CI 1.00–1.08, p = 0.037). Exploratory ROC analysis identified a preoperative SVA value of 4.0 cm with high sensitivity (100%) and moderate specificity (75%) for residual imbalance in this cohort. Transient neurological complications occurred in 12.9% of patients, and radiographic adjacent segment degeneration requiring revision occurred in 9.7%.
conclusionsSacral dome osteotomy with complete L5 reduction and single-level posterior L5–S1 fusion achieved durable radiographic correction of sagittal and coronal deformities in pediatric patients with high-grade dysplastic spondylolisthesis. Exploratory analyses suggested that greater preoperative sagittal vertical axis values were associated with residual postoperative sagittal imbalance, highlighting the importance of careful postoperative follow-up.
Indexed as
Identifiers
What 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.