ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
The invisible hip: radiographic "misses" in hip-spine syndrome and the diagnostic disparity between orthopedic surgeons and neurosurgeons.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 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
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHip-spine syndrome (HSS) presents a diagnostic challenge because hip and lumbar disorders often cause overlapping symptoms. This study aimed to determine the frequency of radiographically evident hip pathology but clinically undiagnosed prior to spine surgery, and to compare diagnostic patterns between orthopedic surgeons (OS) and neurosurgeons (NS).
methodsThis retrospective cohort study used a multi-institutional medical records database from 2003 to 2018. Patients aged 50-85 years who underwent lumbar spine surgery followed by hip arthroplasty within 1 year were included and stratified by spine surgeon specialty (OS vs. NS). Preoperative kidney-ureter-bladder (KUB) or pelvic radiographs were reviewed for hip osteoarthritis (Kellgren-Lawrence grade ≥ 2), or avascular necrosis (Ficat-Arlet stage ≥ 2). Radiographic underdiagnosis was defined as qualifying hip pathology without a corresponding documented hip-related diagnosis prior to spine surgery.
resultsAmong 189 patients, OS more frequently obtained preoperative KUB or pelvic radiographs than NS (83.5% vs. 57.6%, p < 0.001). Among patients with available imaging (n = 134), documented hip-related diagnoses were more common in the OS group (42.0% vs. 22.6%, p = 0.021), whereas radiographic underdiagnosis was more common in the NS group (71.7% vs. 48.1%, p = 0.009). Surgeon specialty remained significantly associated with radiographic underdiagnosis after adjustment (adjusted OR 0.384, 95% CI 0.181-0.815, p = 0.013).
conclusionIn this selected cohort of patients with hip-spine syndrome, orthopedic surgeons more frequently obtained hip-covering radiographs and documented hip-related diagnoses than neurosurgeons. However radiographic underdiagnosis remained common in both groups. These findings support a more structured evaluation of both hip and spinal pathology before spine surgery.
Indexed as
Identifiers
42616078What 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.