Currently submitted to: JMIR Research Protocols
Date Submitted: Jul 13, 2026
Open Peer Review Period: Jul 14, 2026 - Sep 8, 2026
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mechanical Complications and Construct Failure After Resection and Reconstruction of Primary Bone Tumours of the Spine: Protocol for a Systematic Review and Possible Meta-Analysis
ABSTRACT
Background:
Surgical resection and reconstruction for primary bone tumours of the spine aim to achieve en‑bloc or margin‑negative excision and restore spinal stability. Recent case series report mechanical complication rates of around 10 % to 24 % following spinal tumour surgery. Mechanical failures included rod fracture, cage subsidence, and junctional failure. Reported factors associated with mechanical complications in individual studies include spinal level, extent of vertebral resection, reconstructive strategy, intraoperative cage subsidence and duration of follow-up. Radiotherapy and impaired fusion are biologically plausible contributors to construct failure, although their independent effects remain uncertain in the available small and heterogeneous cohorts. Evidence regarding the incidence, distribution and determinants of mechanical complications following resection and reconstruction of primary osseous spinal tumours remains limited.
Objective:
To summarise and quantify the incidence of mechanical complications and construct failure in patients undergoing resection and reconstruction for primary bone tumours affecting spine. To classify the types of complications, identify patient and tumour‑related predictors, and explore how outcomes vary by tumour etiology, spinal level, and reconstructive technique.
Methods:
The review protocol adheres to the PRISMA guidelines and will be registered prospectively. MEDLINE, EMBASE, CINAHL, Scopus and the Cochrane Library will be searched from inception to 2026 for English‑language studies reporting mechanical complications following resection of benign or malignant primary bone tumours of the spine. Two reviewers will independently screen articles and extract data. Risk of bias will be assessed using Joanna Briggs Institute checklists. Mechanical complications will be summarised descriptively, and, if sufficiently homogenous, pooled incidence and risk estimates will be calculated using random‑effects meta‑analysis. Subgroup analyses will examine the influence of tumour type, spinal level, and reconstructive strategy on failure rates.
Results:
This review will provide a structured synthesis of the incidence, type, timing and clinical consequences of mechanical complications following resection and reconstruction for primary osseous spinal tumours. It will examine reported associations with tumour location, extent of resection, reconstructive strategy, adjuvant treatment and duration of follow-up, while identifying limitations in current reporting and priorities for future multicentre research.
Conclusions:
By systematically summarising the available evidence, this review aims to characterise the incidence and predictors of mechanical complications following resection and reconstruction of primary spinal bone tumours. The findings will hopefully inform interpretation of current evidence relevant to preoperative counselling, reconstructive planning and future research, while highlighting uncertainties that require investigation in larger multicentre cohorts.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.