{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T06:37:18Z","timestamp":1770273438745,"version":"3.49.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T00:00:00Z","timestamp":1613779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>Frailty severity may be an important determinant for impaired recovery after cervical spine deformity (CD) corrective surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVE<\/jats:title>\n            <jats:p>To evaluate postop clinical recovery among CD patients between frailty states undergoing primary procedures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>Patients &gt;18\u00a0yr old undergoing surgery for CD with health-related quality of life (HRQL) data at baseline, 3-mo, and 1-yr postoperative were identified. Patients were stratified by the modified CD frailty index scale from 0 to 1 (no frailty [NF] &lt;0.3,\u00a0mild\/severe fraily [F] &gt;0.3).\u00a0Patients in NF and F groups were propensity score matched for TS-CL (T1 slope [TS] minus angle between the C2 inferior end plate and the C7 inferior end plate [CL]) to control for baseline deformity. Area under the curve was calculated for follow-up time intervals determining overall normalized, time-adjusted HRQL outcomes; Integrated Health State (IHS) was compared between NF and F groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>A total of 106 CD patients were included (61.7 yr, 66% F, 27.7 kg\/m<jats:sup>2<\/jats:sup>)\u2014by\u00a0frailty\u00a0group:\u00a052.8% NF, 47.2% F. After propensity score matching for TS-CL (mean: 38.1\u00b0), 38 patients remained in each of the NF and F groups. IHS-adjusted HRQL outcomes from baseline to 1 yr showed a significant difference in Euro-Qol 5 Dimension scores (NF: 1.02, F: 1.07, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a0.016). No significant differences were found in the IHS Neck Disability Index (NDI) and modified Japanese Orthopedic Association between frailty groups (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&gt;\u00a0.05). F patients had more postop major complications (31.3%) compared to the NF (8.9%), <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a0.004, though DJK occurrence and reoperation between the groups was not significant.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>While all groups exhibited improved postop disability and pain scores, frail patients experienced greater amount of improvement in overall health state compared to baseline disability. This signifies that with frailty severity, patients have more room for improvement postop compared to baseline quality of life.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1093\/neuros\/nyab039","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T15:12:06Z","timestamp":1612883526000},"page":"1121-1127","source":"Crossref","is-referenced-by-count":19,"title":["Baseline Frailty Status Influences Recovery Patterns and Outcomes Following Alignment Correction of Cervical Deformity"],"prefix":"10.1227","volume":"88","author":[{"given":"Katherine E","family":"Pierce","sequence":"first","affiliation":[{"name":"Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-4070","authenticated-orcid":false,"given":"Peter G","family":"Passias","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA"}]},{"given":"Alan H","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA"}]},{"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA"}]},{"given":"Waleed","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA"}]},{"given":"Sara","family":"Naessig","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York, New York, USA"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA"}]},{"given":"Themistocles","family":"Protopsaltis","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, New York, USA"}]},{"given":"Robert","family":"Eastlack","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Scripps Clinic, La Jolla, California, USA"}]},{"given":"Robert","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Swedish Neuroscience Institute, Seattle, Washington, USA"}]},{"given":"Douglas","family":"Burton","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[{"name":"Rocky Mountain Scoliosis and Spine, Denver, Colorado, USA"}]},{"given":"Frank","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital for Special Surgery, New York, New York, USA"}]},{"given":"Christopher","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia, USA"}]},{"given":"Justin S","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia, USA"}]},{"given":"Christopher","family":"Ames","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA"}]},{"name":"on behalf of the International Spine Study Group 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