{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T04:24:40Z","timestamp":1787372680764,"version":"build-2736575974"},"reference-count":84,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004331","name":"Johnson and Johnson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To assess clinical and safety outcomes associated with different rod materials and diameters in adult spinal deformity (ASD) surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A systematic literature review and meta-analysis evaluated ASD surgery using pedicle screw fixation systems with rods of different materials and sizes. Postoperative outcomes (i.e., Cobb, sagittal vertical axis, and pelvic tilt angle) and complications (i.e., pseudarthrosis and rod breakage) were assessed. Random effects models (REMs) pooled data for outcomes reported in\u2009\u2265\u20092 studies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 50 studies evaluating ASD surgery using pedicle screw fixation systems, 17 described rod material\/diameter. Postoperative outcomes did not statistically differ between cobalt\u2013chromium (CoCr) vs. titanium (Ti) rods (<jats:italic>n<\/jats:italic>\u2009=\u20092 studies; mean [95% confidence interval (CI)] sagittal vertical axis angle: CoCr 37.00\u00b0 [18.58\u00b0\u201355.42\u00b0] and Ti 32.58\u00b0 [24.62\u00b0\u201340.54\u00b0]; mean [95% CI] pelvic tilt angle: CoCr 26.20\u00b0 [22.87\u00b0\u201329.53\u00b0] and Ti 20.15\u00b0 [18.0\u00b0\u201322.31\u00b0]). The pooled proportion (95% CI) of pseudarthrosis was 15% (7\u201322%) for CoCr and 12% (\u2212\u00a08\u201332%) for stainless steel (SS) (<jats:italic>n<\/jats:italic>\u2009=\u20092 studies each; Chi<jats:sup>2<\/jats:sup>\u2009=\u20090.07, <jats:italic>p<\/jats:italic>\u2009=\u20090.79). The pooled proportion (95% CI) of broken rods was 12% (1\u201322%) for Ti (<jats:italic>n<\/jats:italic>\u2009=\u20093 studies) and 10% (2\u201319) for CoCr (<jats:italic>n<\/jats:italic>\u2009=\u20091 study). Among 6.0\u20136.35\u00a0mm rods, the pooled (95% CI) postoperative Cobb angle (<jats:italic>n<\/jats:italic>\u2009=\u20092) was 12.01\u00b0 (9.75\u00b0\u201314.28\u00b0), sagittal vertical axis angle (<jats:italic>n<\/jats:italic>\u2009=\u20094) was 35.32\u00b0 (30.02\u00b0\u201340.62\u00b0), and pelvic tilt angle was 21.11\u00b0 (18.35\u00b0\u201323.86\u00b0).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>For ASD patients undergoing posterior fixation and fusion, there are no statistically significant differences in postoperative outcomes or complications among rods of varying materials and diameters. Benchmark postsurgical outcomes and complication rates by rod material and diameter are provided.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of Evidence<\/jats:title>\n                <jats:p>III<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s43390-022-00556-y","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T11:03:59Z","timestamp":1659092639000},"page":"1265-1278","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Systematic review and meta-analysis for the impact of rod materials and sizes in the surgical treatment of adult spine deformity"],"prefix":"10.1007","volume":"10","author":[{"given":"Dawn","family":"Bowden","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Michielli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Merrill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Will","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"issue":"10193","key":"556_CR1","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/s0140-6736(19)31125-0","volume":"394","author":"BG Diebo","year":"2019","unstructured":"Diebo BG, Shah NV, Boachie-Adjei O et al (2019) Adult spinal deformity. 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