Evidence map›Paper›PMID 37853938›Full record

ArticleOrthopaedic surgery2023

Diabetes-related Screw Loosening: The Distinction of Surgical Sites and the Relationship among Diabetes, Implant Stabilization and Clinical Outcomes.

Tianji Wang, Jing Wang, Xiaofan Hu, Kaili Hao, Geng Xiang, Zixiang Wu, Zhensheng Ma, Tianqing Li, Yu Chen, Xiong Zhao and 5 more

Open access · goldAbstract read
In one paragraph

Article in Orthopaedic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
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

5 citing papers in PubMed, 3 citations in OpenAlex.

  1. Multimodal model predicts screw loosening at user-specified postoperative time points after single-level lumbar interbody fusion.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
    Article
  2. Article
  3. Review
  4. Risk factors for pedicle screw loosening: a comprehensive review.Journal of orthopaedic surgery and research · 2025
    Review
  5. 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

15 authors at 1 institution in 1 country.

Tianji WangDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Jing WangDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Xiaofan HuDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Kaili HaoDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Geng XiangDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Zixiang WuDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Zhensheng MaDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Tianqing LiDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Yu ChenDepartment of Critical Care Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Xiong ZhaoDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Yang ZhangDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Tiancheng MaDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Jingjuan RenDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Wei LeiDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.ORCID https://orcid.org/0000-0002-7346-6915
Yafei FengDepartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Xijing Hospital · CN

Funding

Key Research and Development Program of Shaanxi Province of China 2020SF-186National Natural Science Foundation of China 81871799National Natural Science Foundation of China 81902184National Natural Science Foundation of China 82102603National Natural Science Foundation of China 82172393Natural Science Foundation of Shaanxi Province of China 2019JM-465
6 · The paper itself

Abstract

objectivesDiabetes mellitus (DM) is correlated with poor clinical outcomes in spinal surgery. However, the effect of it on screw stabilization has not been investigated. The aim of this study was to evaluate the screw loosening rate and postoperative outcomes in diabetic patients and to identify potential risk factors associated with loosening.

methodsThis was a retrospective study. Two hundred and forty-three patients who received cervical or lumbar internal fixation between 2015 and 2019 were enrolled. Screw loosening was assessed on radiography, and clinical outcomes were evaluated by the improvement of visual analogue scale (VAS), Oswestry disability index (ODI) or Japanese Orthopaedic Association (JOA) scores. The relationship of DM, screw loosening and clinical outcomes were analyzed with chi-square tests and regression analyses.

resultsOne hundred and twenty-two patients (50.2%) with diabetes were included in this study. Diabetes led to the increase of the rate of screw loosening in the lumbar spine, while the loosening rate did not vary significantly in the cervical spine. The occurrence of screw loosening in the lumbar spine was more likely to be associated with clinical outcomes for motor performance including walking and sitting. However, no significant effect on JOA and VAS scores in the cervical spine of screw loosening was found. Moreover, the history of DM affected the outcomes of the patients who underwent spinal surgery.

conclusionDM had an adverse effect on screw stabilization. The impaired improvement of clinical outcomes in diabetics after spinal surgery was related to screw loosening. In addition to the direct effects on operative wounds and neural function, the impact on the screws due to DM was also worth noting.

Indexed as

Diabetes MellitusPedicle ScrewsSpinal FusionBone ScrewsHumansLumbar VertebraeRetrospective StudiesTreatment OutcomeClinical outcomesDiabetes mellitusScrew looseningSpine surgery

Identifiers

PMID37853938
PMCPMC10694010
OpenAlexW4387765396

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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 Socratic graph.