Review for 10.1186/s12876-018-0738-6 (2018)

Reviewer ’s report  
 
Title: Prevalence and key radiographic spinal malalignment par ameters that influence the risk 
for gastroesophageal reflux disease in  patients treated surgically for adult spinal deformity  
 
Version: 1 Date: 14 Nov 2017  
 
Reviewer: Mitsushige Sugimoto  
 
Reviewer's report:  
 
Major comments:  
 
1. In general, the epidemiology and pathology of GERD in patients with adult spinal 
deformit y is known.  
 
 
 
2. Sensitivity of the FSSG for diagnosis of GERD is about 70%. In addition, GERD 
included reflux esophagitis and non -erosive reflux esophagitis. In this study, because 
most of patients grouped as GERD -positive were dosed PPI, those may be pati ents with 
NERD or functional heart burn.  
 
 
 
3. Serious problem of this is luck of endoscopic evaluation, as authors suggested.  
 
 
 
4. Most of readers of this study is Gastroenterologist. Therefore, authors should add detail 
explanation about spinal deformity -related words.  
 
 
 
5. Did authors enroll all of patients with spinal deformity who were treated with 
thoracolumbar corrective surgery between April 2010 and March 2014?  
 
 
 
6. Ethical committee approved in 2014. However, this study was performed between April 
2010 and March 2014. Did authors receive informed consent from all eligible patients to 
enroll this study, not operation?  
 
 
 
7. Intake of NSAIDs is risk factor for development of GERD. This situation may influence 
occurrence of GERD -related symptoms.  
 
 
 
8. Patients improved GERD -related symptom after operation might stop intake of PPI.  
Because PPI is first -line drug for GERD treatment, discontinuous of PPI may affect 
FSSG score.  
 
 
 
9. What did difference between standing and FBB position mean?  
 
 
 
10. Please show parameter s used at the multivariate analysis.  
 
 
 
11. Fig2; Please divided FSSG score into acid -related score and dysmotility score.  
 
 
 
12. Fig3; Please show association with FSSG score and TLK (FBB) at post -operation.  
 
 
 
13. If possible, authors should compare with adult  spinal deformity patients operated and not 
for GERD -related symptoms.  
 
 
 
Are the methods appropriate and well described?  
If not, please specif y what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects requ ire further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
 
 
 
Declaration of competing  interests  
Please complete a declaration of competing interests, considering the following questions:  
 
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3. Do you hold or are you currently applying for any patents relating to the content of the  
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holds  or has applied f or patents relating to the content of the manuscript?  
 
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below.  If your reply is yes to any, please give details below.  
 
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