{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T04:25:38Z","timestamp":1793679938440,"version":"4.5.1"},"reference-count":45,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Although dyslipidemia has been implicated in impaired bone healing, the role of high-density lipoprotein cholesterol (HDL-C) in spinal fusion outcomes remains poorly defined. Emerging evidence suggests that extremely elevated HDL-C levels may be associated with adverse osseous events. The objective of this study was to evaluate the association between HDL-C levels and rates of pseudoarthrosis and reoperation following single-level lumbar interbody fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The TriNetX Research Network was queried for adult patients who underwent single level lumbar fusion during the 20-years period ended December 2, 2023. The high HDL-C cohort was designated by HDL-C \u226570.1\u00a0mg\/dL, reflecting one standard deviation above the mean for all patients in the database. One standard deviation below the mean denoted the low HDL-C group (\u226432.1\u00a0mg\/dL). Propensity score matching was performed 1:1 according to demographics and comorbidities. Pseudoarthrosis diagnosis and reoperation were assessed at 6\u00a0months, 1\u00a0year, and 2\u00a0years postoperatively utilizing risk ratios (RR) and 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After propensity matching, 1316 patient pairs were included. Patients with elevated HDL-C demonstrated significantly higher rates of pseudoarthrosis at 6\u00a0months, 1\u00a0year, and 2\u00a0years postoperatively. Early reoperation risk was also significantly increased in the high HDL-C cohort within 6\u00a0months, though differences were not sustained at later time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated HDL-C was independently associated with increased risk of pseudoarthrosis following single-level lumbar fusion. These findings suggest that HDL-C may represent an underrecognized metabolic risk factor for impaired spinal fusion and warrants further investigation into underlying mechanisms and its possible utility in preoperative optimization programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261443916","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T08:31:56Z","timestamp":1776846716000},"page":"3786-3793","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigating the Relationship Between High Density Lipoprotein Cholesterol and Fusion Outcomes Following Single Level Lumbar Fusion: A Propensity Matched Analysis"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3878-5183","authenticated-orcid":false,"given":"Kyle","family":"Stump","sequence":"first","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Han","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Morar","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Lee","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Aynaszyan","sequence":"additional","affiliation":[{"name":"Temple University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhara","family":"Patel","sequence":"additional","affiliation":[{"name":"Temple University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Pazionis","sequence":"additional","affiliation":[{"name":"Temple University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-021-06861-w"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.08.026"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-018-0951-3"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003980"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-015-3154-y"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200908000-00003"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.3171\/2011.4.SPINE10822"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2025.03.031"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2023.07.136"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyab316"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.3171\/2020.5.FOCUS20289"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.541"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.511799"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2024.116693"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0298610"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2015.00165"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000004895"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000005570"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.08.038"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx163"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.0912"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.5124"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232314616"},{"key":"e_1_3_5_25_2","unstructured":"TriNetX. 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