Supplemental Table 1. Binomial Regression Analysis for Fusion.

Factor B S.E. Wald df Sig. Exp(B) 95% C.I.for EXP(B)

Lower Upper

Back Pain

(+) 0.353 1.414 0.062 1 0.803 1.423 0.089 22.753

ASIA PreOp 3.521 4 0.475

ASIA B -

PreOp 66.28

7 34694.448 0 1 0.998 0 0 .

ASIA C -

PreOp 42.47

5 30489.448 0 1 0.999 0 0 .

ASIA D -

PreOp 41.55

4 30489.448 0 1 0.999 0 0 .

ASIA E -

PreOp 44.06

4 30489.448 0 1 0.999 0 0 .

Sensory

PreOp 0.23 2 0.891

Sensory 1 21.76

PreOp 1 17691.358 0 1 0.999 2822351580 0 .

Sensory 2 22.24

PreOp 4 17691.358 0 1 0.999 4574814860 0 .

Bladder -1.32 1.39 0.903 1 0.342 0.267 0.018 4.069

PreOp (+)

Bowel

PreOp (+) -1.585 1.796 0.779 1 0.377 0.205 0.006 6.921

Multiple

Injuries (+) 1.657 0.897 3.412 1 0.065 5.245 0.904 30.435

Listhesis

Grade 2.943 4 0.567

Listhesis

Grade 1 1.914 2.381 0.646 1 0.421 6.782 0.064 721.753

Listhesis

Grade 2 2.84 2.315 1.505 1 0.22 17.111 0.183 1598.435

Listhesis

Grade 3 3.865 2.769 1.948 1 0.163 47.709 0.21 10853.576

Listhesis

Grade 4 2.588 2.645 0.958 1 0.328 13.3 0.075 2370.679

Dimar

Classificatio

n 4.302 4 0.367

Dimar

Classificatio

n2 2.486 1.293 3.696 1 0.055 12.015 0.953 151.528

Dimar

Classificatio

n3 0.799 1.533 0.272 1 0.602 2.224 0.11 44.906

Dimar 21.83 11496.903 0 1 0.998 3051638627 0 .

Classificatio
 n5 9

Dimar

Classificatio

n6 0.413 1.107 0.139 1 0.709 1.512 0.173 13.222

LS vs Non-

LS (LS) -1.811 1.116 2.632 1 0.105 0.163 0.018 1.458

Disc Lesion

(+) -2.367 1.277 3.439 1 0.064 0.094 0.008 1.144

PSF vs IB

Fusion (IB) 3.353 1.262 7.058 1 0.008 28.575 2.409 338.934

Constant 19.28

5 24831.866 0 1 0.999 237335927

Abbreviations: PSF, posterior spinal instrumentation + fusion; IB, interbody fusion with

supplemental posterior instrumentation  fusion; LS, lumbosacral level; Non-LS, non-

lumbosacral level.

* The binomial regression model for fusion is significant at x2(21)=52.554, p<0.001. The model

explained 63.3% (Nagelkerke r2=0.633) of the variance in fusion and correctly classified 91.8%

of cases. Only the treatment type (PSF vs IB Fusion) was significant in the model at p=0.008,

where IB fusion had 28.6X higher odds for developing fusion compared to PSF.
Supplemental Table 2. Evidence Summary for Outcomes.*

Outcomes Quality of Conclusions / Comments Baselin Upgrade /

Evidence e Downgrade

Levels

Fusion Very Low Overall fusion rates of 73.6% Low Downgrade

(92/124) Significant difference in (serious risk for

fusion outcomes between different bias,

treatment types using Pearson Chi- inconsistent,

square test [x2(3)=17.306, indirect)

p=0.001]. Cases included in

analysis were extrapolated from

case series and case reports.

Ambulation Very Low 94.4% (118/124) of all patients Low Downgrade

were ambulatory after treatment. (serious risk for

No difference in ambulation status bias,

postoperatively in different inconsistent,

treatment groups. Cases included indirect)

in analysis were extrapolated from

case series and case reports.

Pain Very Low No complaints of pain after Low Downgrade

treatment in 80% (90/124) of (serious risk for

patients. Significant overall bias,

improvement in pain status after inconsistent,

 treatment. Cases included in indirect)

analysis were extrapolated from

case series and case reports.

Neurologic Very Low Majority of patients (74.4%, Low Downgrade

Status 93/124) had no neurologic deficits (serious risk for

after treatment. Significant overall bias,

improvement in neurologic status inconsistent,

after treatment. Cases included in indirect)

analysis were extrapolated from

case series and case reports.

Complication Very Low Overall complication rate was Low Downgrade

s 22.4% (28/125) for all treatment (serious risk for

groups. Cases included in analysis bias,

were extrapolated from case series inconsistent,

and case reports. indirect)

* Baseline quality of evidence is Low for Level III/IV studies, and High for Level I/II studies.

The baseline quality may be upgraded or downgraded based on the following factors: upgrade =

(1) large magnitude of effect, or (2) dose-response gradient; downgrade = (1) inconsistency of

results, (2) indirectness of evidence, (3) imprecision of the effect estimates, (4) risk of bias.

Overall quality of evidence may be graded as high, moderate, low, or very low.