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
Multifactorial prediction of mechanical complications after lumbar fusion using bone quality and turnover markers.
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
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the predictive value of preoperative bone health indices including T-score, bone mineral density (BMD), Hounsfield units (HU), and serum bone turnover markers for postoperative mechanical complications following lumbar fusion surgery.
methodsThis retrospective study analyzed prospectively collected data from 120 patients who underwent lumbar fusion with pedicle screw instrumentation between August 2021 and June 2024. Preoperative assessments included dual-energy X-ray absorptiometry (DEXA)-derived BMD and T-scores, computed tomography-derived HU values, and serum bone turnover markers including procollagen type I N-terminal propeptide (P1NP) and tartrate-resistant acid phosphatase type 5b (TRACP-5b). Mechanical complications were evaluated radiographically at ≥ 12 months postoperatively. Receiver operating characteristic (ROC) curve analyses were performed for individual parameters, and multivariable logistic regression was used to identify independent predictors.
resultsMechanical complications occurred in 40 patients (33%). In univariate analysis, patients with complications were significantly older and had lower femoral BMD and T-scores and higher P1NP levels (all p < 0.05). ROC analysis demonstrated modest predictive ability for femoral T-score (AUC = 0.688) and BMD (AUC = 0.681). In multivariable logistic regression, TRACP-5b (OR = 1.02, p = 0.042) and the number of fused levels (OR = 5.24, p = 0.001) were associated with complications. A multivariate model combining significant variables yielded an AUC of 0.830, indicating good overall discrimination.
conclusionsPreoperative T-score, BMD, and HU values alone showed limited predictive accuracy for mechanical complications after lumbar fusion. However, integrating serum bone turnover markers and surgical factors substantially improved predictive performance. A multifactorial preoperative assessment incorporating bone density, metabolic, and mechanical parameters may better stratify risk and guide surgical planning in patients with poor bone quality.
Identifiers
42875592What 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.