| Title |
Pseudarthrosis in adult and pediatric spinal deformity surgery: a systematic review of the literature and meta-analysis of incidence, characteristics, and risk factors
|
|---|---|
| Published in |
Neurosurgical Review, February 2018
|
| DOI | 10.1007/s10143-018-0951-3 |
| Pubmed ID | |
| Authors |
Nathan E. How, John T. Street, Marcel F. Dvorak, Charles G. Fisher, Brian K. Kwon, Scott Paquette, Justin S. Smith, Christopher I. Shaffrey, Tamir Ailon |
| Abstract |
We conducted a systematic review with meta-analysis and qualitative synthesis. This study aims to characterize pseudarthrosis after long-segment fusion in spinal deformity by identifying incidence rates by etiology, risk factors for its development, and common features. Pseudarthrosis can be a painful and debilitating complication of spinal fusion that may require reoperation. It is poorly characterized in the setting of spinal deformity. The MEDLINE, EMBASE, and Cochrane databases were searched for clinical research including spinal deformity patients treated with long-segment fusions reporting pseudarthrosis as a complication. Meta-analysis was performed on etiologic subsets of the studies to calculate incidence rates for pseudarthrosis. Qualitative synthesis was performed to identify characteristics of and risk factors for pseudarthrosis. The review found 162 articles reporting outcomes for 16,938 patients which met inclusion criteria. In general, the included studies were of medium to low quality according to recommended reporting standards and study design. Meta-analysis calculated an incidence of 1.4% (95% CI 0.9-1.8%) for pseudarthrosis in adolescent idiopathic scoliosis, 2.2% (95% CI 1.3-3.2%) in neuromuscular scoliosis, and 6.3% (95% CI 4.3-8.2%) in adult spinal deformity. Risk factors for pseudarthrosis include age over 55, construct length greater than 12 segments, smoking, thoracolumbar kyphosis greater than 20°, and fusion to the sacrum. Choice of graft material, pre-operative coronal alignment, post-operative analgesics, and sex have no significant impact on fusion rates. Older patients with greater deformity requiring more extensive instrumentation are at higher risk for pseudarthrosis. Overall incidence of pseudarthrosis requiring reoperation is low in adult populations and very low in adolescent populations. |
X Demographics
The data shown below were collected from the profiles of 5 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 20% |
| United Kingdom | 1 | 20% |
| Unknown | 3 | 60% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 81 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 81 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 13 | 16% |
| Student > Doctoral Student | 12 | 15% |
| Student > Ph. D. Student | 8 | 10% |
| Student > Bachelor | 8 | 10% |
| Other | 4 | 5% |
| Other | 10 | 12% |
| Unknown | 26 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 34 | 42% |
| Nursing and Health Professions | 4 | 5% |
| Unspecified | 2 | 2% |
| Chemical Engineering | 1 | 1% |
| Business, Management and Accounting | 1 | 1% |
| Other | 6 | 7% |
| Unknown | 33 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 July 2019.
All research outputs
#14,374,920
of 23,020,670 outputs
Outputs from Neurosurgical Review
#297
of 634 outputs
Outputs of similar age
#239,144
of 437,329 outputs
Outputs of similar age from Neurosurgical Review
#4
of 15 outputs
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So far Altmetric has tracked 634 research outputs from this source. They receive a mean Attention Score of 2.5. This one has gotten more attention than average, scoring higher than 50% of its peers.
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We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.