ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024
Influence of implant density on mechanical complications in adult spinal deformity surgery.
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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Implant density reduction to avoid proximal junctional failure in adult spine surgery: Computer models and simulations.North American Spine Society journal · 2025Article
- Article
- Stabilization of L5 pedicle Subtraction osteotomies (PSO) with ≥ 6-rods and bilateral dual pelvic fixation with osseointegrative implants: surgical technique description and early postoperative outcomes.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 · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe purpose was to analyze how rod characteristics, screw density and cages influence the incidence of mechanical complications compared to patient-related factors and alignment in adult spinal deformity instrumented T9-T11 to pelvis.
methodsRegister data of 302 patients was analyzed. Relative lumbar lordosis (RLL) and relative sagittal alignment (RSA) was measured. Surgical data included rod characteristics, pedicle screw density and interbody cages. Univariate and multivariate logistic regression models were used.
resultsPseudarthrosis occurred in 24.1%. On univariate analysis Odds Ratio (OR) was 0.74 for ≥ 3 cages (p = 0.452), 0.48 for 4 rods (p = 0.008), 4.30 for high screw density (p = 0.001). Patient-related factors were non-significant. Multivariate OR was 0.59 for 4 rods (p = 0.084) and 4.67 for high screw density (p = 0.005). PJK/PJF occurred in 19.2%. Age > 60 had an OR 2.83 (p = 0.023), postoperative RSA malaligned OR 2.84 (p = 0.030), severely malaligned OR 6.54 (p < 0.001). Implant characteristics were non-significant. Multivariate OR was 1.26 for age > 60 (p = 0.657), 2.32 for malaligned RSA (p = 0.097), 5.69 for severely malaligned RSA (p = 0.001). Screw loosening occurred in 8.9%. Univariate OR was 0.95 for ≥ 3 cages (p = 0.920), 1.64 for 4 rods (p = 0.235), 0.25 for high screw density 1.5-2 (p = 0.011). Patient-related factors were non-significant. Multivariate OR for high screw density was 0.23 (p = 0.022).
conclusionFour rods decrease the pseudarthrosis risk. Cages have a secondary role. High screw density doesn't prevent from pseudarthrosis. Postoperative malalignment is the main PJK/PJF risk factor. Age plays a secondary role. Implant characteristics have a minor influence. High screw density constructs have a lower risk for screw loosening. LEVEL OF EVIDENCE: 3-Retrospective register study.
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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 Socratic graph.