Evidence map›Paper›PMID 42760478›Full record

ArticleSpine deformity2026

Postoperative thoracic kyphosis morphology following adult spinal deformity surgery: an analysis of fused and unfused segments.

Renaud Lafage, Jonathan C Elysee, Alan H Daniels, Bassel G Diebo, Leonard Chatelain, Christopher P Ames, Shay Bess, Themistocles Protopsaltis, Robert K Eastlack, Munish C Gupta and 11 more

Abstract read
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In one paragraph

Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

21 authors.

Renaud LafageDepartment of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, 130 East 77th Street, 12th Floor, New York, NY, 10075, USA. renaud.lafage@gmail.com.ORCID http://orcid.org/0000-0002-4820-1835
Jonathan C ElyseeDepartment of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, 130 East 77th Street, 12th Floor, New York, NY, 10075, USA.ORCID http://orcid.org/0000-0002-7190-7692
Alan H DanielsDepartment of Orthopaedic Surgery, University Orthopedics, Providence, RI, USA.ORCID http://orcid.org/0000-0001-9597-4139
Bassel G DieboDepartment of Orthopaedic Surgery, University Orthopedics, Providence, RI, USA.ORCID http://orcid.org/0000-0002-7835-2263
Leonard ChatelainDepartment of Orthopedic Surgery, Hôpital Européen Georges Pompidou, Paris, France.ORCID http://orcid.org/0000-0002-0939-6844
Christopher P AmesDepartment of Neurosurgery, University of California San Francisco Spine Center, San Francisco, CA, USA.ORCID http://orcid.org/0000-0003-2618-3098
Shay BessDepartment of Orthopaedic Surgery, Denver International Spine Center, Denver, CO, USA.ORCID http://orcid.org/0000-0002-9697-8999
Themistocles ProtopsaltisDepartment of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
Robert K EastlackDepartment of Orthopedics, Scripps Clinic, La Jolla, CA, USA.
Munish C GuptaDepartment of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.ORCID http://orcid.org/0000-0002-4711-4377
Richard HostinDepartment of Orthopaedic Surgery, Southwest Scoliosis Institute, Dallas, TX, USA.ORCID http://orcid.org/0000-0003-4558-003X
Khaled M KebaishDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-1235-6202
Han Jo KimDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.ORCID http://orcid.org/0000-0002-7482-6994
Eric O KlinebergDepartment of Orthopaedic Surgery, UT Health Houston, Houston, TX, USA.ORCID http://orcid.org/0000-0003-1408-106X
Gregory M MundisDepartment of Orthopedics, Scripps Clinic, La Jolla, CA, USA.ORCID http://orcid.org/0000-0002-1483-7245
David O OkonkwoDepartment of Neurological Surgery, Division of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Christopher I ShaffreyDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.ORCID http://orcid.org/0000-0001-9760-8386
Justin S SmithDepartment of Neurosurgery, University of Virginia Medical Center, Charlottesville, VA, USA.
Frank J SchwabDepartment of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, 130 East 77th Street, 12th Floor, New York, NY, 10075, USA.ORCID http://orcid.org/0000-0003-2307-3037
Virginie LafageDepartment of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, 130 East 77th Street, 12th Floor, New York, NY, 10075, USA.ORCID http://orcid.org/0000-0002-0119-7111
International Spine Study Group (ISSG)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPredicting post-operative changes in thoracic kyphosis (TK) remains challenging in adult spinal deformity (ASD) surgery. This study aimed to quantify both iatrogenic and reciprocal changes in TK following lumbar correction and assess their maintenance at 2-year follow-up.

methodsA retrospective analysis was performed on 356 ASD patients treated with posterior instrumentation from T9-11 to the pelvis, with a minimum 2-year follow-up. TK values were compared with normative data. Multivariate analysis identified thoracolumbar parameters associated with reciprocal thoracic changes and proximal failure.

resultsPre-op TK (median 34°) was normal for 59.8% and hypokyphotic for 39.0% of patients. At 6 weeks, 79.1% of initially hypokyphotic patients normalized, while 11.3% of normokyphotic patients deteriorated. Postoperative TK increase correlated with lumbar lordosis gain (p<0.001), controlling for pre-op alignment and demographics (R

conclusionIn ASD surgery with Upper Instrumented Vertebra (UIV) between T9 and T11, changes in TK were largely proportional to lumbar correction, leading to normalization in most cases. However, age, the location of lumbar correction, and early post-operative thoracic shape independently predicted thoracic failure, highlighting the need for tailored alignment strategies.

Indexed as

Adult spinal deformityThoracic failureThoracic reciprocal changeUnfused thoracic spine

Identifiers

PMID42760478

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