Evidence map›Paper›PMID 42621763›Full record

ArticleGlobal spine journal2026

Fusion Construct Length is Associated With Increased Risk of Delayed Reoperation Following Cervical and Lumbar Fusion.

Roman Rahmani, Evan R Simpson, Zachary T Mills, Hunter Hitchens, Jon I White, Casey Slattery, Vance Gardner, Jeremy Smith

Abstract read
In one paragraph

Article in Global spine 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

8 authors.

Roman RahmaniHoag Orthopedics, Irvine, CA, USA.
Evan R SimpsonHoag Orthopedics, Irvine, CA, USA.ORCID 0009-0004-6507-5326
Zachary T MillsHoag Orthopedics, Irvine, CA, USA.ORCID 0009-0004-0518-6729
Hunter HitchensHoag Orthopedics, Irvine, CA, USA.
Jon I WhiteHoag Orthopedic Institute, Irvine, CA, USA.
Casey SlatteryHoag Orthopedic Institute, Irvine, CA, USA.
Vance GardnerHoag Orthopedics, Irvine, CA, USA.
Jeremy SmithHoag Orthopedic Institute, Irvine, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Study DesignRetrospective cohort study.ObjectiveTo identify factors associated with delayed reoperation following cervical and lumbar fusion and characterize long-term healthcare utilization.MethodsPatients undergoing cervical or lumbar fusion for degenerative pathology within the PearlDiver Mariner 170 dataset were identified using ICD-10 and CPT codes. Delayed reoperation was assessed using narrow and broad definitions at 2-, 5-, and 10-year follow-up. Kaplan-Meier survivorship analysis and multivariable Cox proportional hazards modeling were performed.ResultsA total of 286,398 cervical and 175,874 lumbar fusion patients met inclusion criteria for the 2-year cohort. By 10 years, narrow delayed reoperation occurred in 11.16% of cervical fusion patients and 14.07% of lumbar fusion patients (p<0.001), while broad delayed reoperation occurred in 14.67% and 17.1%, respectively (p<0.001). Fusion construct length demonstrated the largest observed association with delayed reoperation across cervical and lumbar cohorts. Three-or-more level cervical fusion was associated with a nearly tenfold increase in reoperation risk (HR 9.62, p<0.001), while three-or-more level lumbar fusion demonstrated the highest risk among lumbar constructs (HR 3.79, p<0.001). Lumbar fusion patients demonstrated significantly greater postoperative complication rates and cumulative healthcare utilization burden (p<0.001).ConclusionsDelayed reoperation accumulates progressively following cervical and lumbar fusion and is associated with substantial long-term healthcare burden. Across all analyses, fusion construct length was consistently associated with increased risk of delayed reoperation, exceeding the influence of traditional patient-specific risk factors. These findings highlight construct length as a critical determinant of long-term surgical burden and may improve patient counseling, risk stratification, and operative decision-making.

Indexed as

cervical fusioncostlumbar fusionoutcomespearldiverreoperation

Identifiers

PMID42621763
PMCPMC13493630

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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.