{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T04:25:40Z","timestamp":1793679940527,"version":"4.5.1"},"reference-count":22,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"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 study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare all-cause revision rates after lumbar fusion among asthmatic patients receiving maintenance inhaled corticosteroid (ICS) therapy, asthmatic patients without maintenance ICS, and asthma-free controls without ICS exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three cohorts of patients undergoing lumbar fusion were identified from a real-world health records database: (1) asthmatic patients with maintenance ICS therapy, (2) asthmatic patients without ICS therapy, and (3) asthma-free controls. Pairwise 1:1 propensity-score matching was performed to control for baseline differences in comorbidities, including known osteoporosis and systemic steroid exposure. All-cause revision rates were compared between cohorts at two- and five-years post-fusion using Chi-square tests and Kaplan-Meier analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Asthmatic patients on maintenance ICS were significantly more likely than asthmatic patients without ICS to undergo revision at 2 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, OR = 3.11, 95%CI = 2.25-4.31) and 5 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, OR = 3.16, 95%CI = 2.34-4.19) years following fusion. Asthmatic patients receiving maintenance ICS were also more likely than asthma-free controls to undergo revision at 2 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, OR = 3.48, 95%CI = 2.47-4.90) and 5 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, OR = 3.98, 95%CI = 2.92-5.42) years. Asthmatic patients without maintenance ICS had similar hazard of revision over 5 years of follow-up compared to asthma-free controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.082, HR = 1.07; 95%CI = 0.99-1.15).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Maintenance ICS therapy is associated with increased risk of revision following lumbar fusion in asthmatic patients. ICS use, traditionally considered low-risk, may have clinically relevant effects on lumbar fusion outcomes. Future studies are warranted to further elucidate the biological mechanisms driving revision in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261448191","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:13:45Z","timestamp":1777468425000},"page":"3894-3904","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Maintenance Inhaled Corticosteroid Use is Associated With Increased Revision Risk in Asthmatic Patients Undergoing Lumbar Fusion"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9967-4790","authenticated-orcid":false,"given":"Eric","family":"Mao","sequence":"first","affiliation":[{"name":"The Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Thai","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3447-7152","authenticated-orcid":false,"given":"Krystell E.","family":"Ceballos-Alvarez","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2004-9448","authenticated-orcid":false,"given":"Andreas K.","family":"Demetriades","sequence":"additional","affiliation":[{"name":"Royal Infirmary Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarvdeep","family":"Dhatt","sequence":"additional","affiliation":[{"name":"Postgraduate Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3169-6437","authenticated-orcid":false,"given":"Bhavuk","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Vadala","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Campus Bio-Medico di Roma"},{"name":"Fondazione Policlinico Universitario Campus Bio-Medico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-3365","authenticated-orcid":false,"given":"Amit","family":"Jain","sequence":"additional","affiliation":[{"name":"The Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.14444\/8296"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-021-07018-5"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/1749-799X-9-15"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201904-0903SO"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02138-3"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-018-1588-2"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOSGlobal-D-20-00001"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20210416-01"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.9.941"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(98)70159-9"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.151.2.7842187"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-72-3-530"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.293.6560.1463"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.1998.13.8.1283"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.105.6.1722"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.47.6.414"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.06.060"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.3171\/2020.5.FOCUS20289"},{"key":"e_1_3_5_20_2","first-page":"100327","article-title":"The influence of osteoporosis on mechanical complications in lumbar fusion surgery: a systematic review","volume":"18","author":"Filley A","year":"2024","unstructured":"Filley A, Baldwin A, Ben-Natan AR, et al. The influence of osteoporosis on mechanical complications in lumbar fusion surgery: a systematic review. 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