{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:02:30Z","timestamp":1790143350085,"version":"4.0.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["GeroScience"],"DOI":"10.1007\/s11357-026-02481-8","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:19:08Z","timestamp":1787271548000},"page":"6289-6298","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Examination of DNAm PhenoAge as an epigenetic biomarker for perioperative risk in adult spinal deformity surgeries"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-7406","authenticated-orcid":false,"given":"Michael P.","family":"Kelly","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Hills","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Jo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breton","family":"Line","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Klineberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferran","family":"Pellise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Kebaish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munish C.","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J.","family":"Schwab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"2481_CR1","doi-asserted-by":"crossref","unstructured":"Lafage R, Bass RD, Klineberg E, Smith JS, Bess S, Shaffrey C, et al. Complication rates following adult spinal deformity surgery: evaluation of the category of complication and chronology. Spine (Phila Pa 1976). 2024;49(12):829\u201339.","DOI":"10.1097\/BRS.0000000000004969"},{"key":"2481_CR2","doi-asserted-by":"crossref","unstructured":"Passias PG, Mir JM, Dave P, Smith JS, Lafage R, Gum J, et al. Factors associated with the maintenance of cost-effectiveness at 5 years in adult spinal deformity corrective surgery. Spine (Phila Pa 1976). 2024.","DOI":"10.1227\/neu.0000000000002809_326"},{"key":"2481_CR3","doi-asserted-by":"crossref","unstructured":"Ames CP, Smith JS, Gum JL, Kelly M, Vila-Casademunt A, Burton DC, et al. Utilization of predictive modeling to determine episode of care costs and to accurately identify catastrophic cost nonwarranty outlier patients in adult spinal deformity surgery: a step toward bundled payments and risk sharing. Spine (Phila Pa 1976). 2020;45(5):E252-E65.","DOI":"10.1097\/BRS.0000000000003242"},{"issue":"4","key":"2481_CR4","doi-asserted-by":"publisher","first-page":"587","DOI":"10.3171\/2019.3.SPINE181452","volume":"31","author":"F Pellise","year":"2019","unstructured":"Pellise F, Serra-Burriel M, Smith JS, Haddad S, Kelly MP, Vila-Casademunt A, et al. Development and validation of risk stratification models for adult spinal deformity surgery. J Neurosurg Spine. 2019;31(4):587\u201399.","journal-title":"J Neurosurg Spine"},{"issue":"3","key":"2481_CR5","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s12178-016-9354-7","volume":"9","author":"JA Osorio","year":"2016","unstructured":"Osorio JA, Scheer JK, Ames CP. Predictive modeling of complications. Curr Rev Musculoskelet Med. 2016;9(3):333\u20137.","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"4","key":"2481_CR6","doi-asserted-by":"publisher","first-page":"573","DOI":"10.18632\/aging.101414","volume":"10","author":"ME Levine","year":"2018","unstructured":"Levine ME, Lu AT, Quach A, Chen BH, Assimes TL, Bandinelli S, et al. An epigenetic biomarker of aging for lifespan and healthspan. Aging (Albany NY). 2018;10(4):573\u201391.","journal-title":"Aging (Albany NY)"},{"issue":"11","key":"2481_CR7","doi-asserted-by":"publisher","first-page":"3060","DOI":"10.1007\/s00586-022-07379-5","volume":"31","author":"S Murata","year":"2022","unstructured":"Murata S, Tsutsui S, Hashizume H, Minamide A, Nakagawa Y, Iwasaki H, et al. Importance of physiological age in determining indications for adult spinal deformity surgery in patients over 75 years of age: a propensity score matching analysis. Eur Spine J. 2022;31(11):3060\u20138.","journal-title":"Eur Spine J"},{"key":"2481_CR8","doi-asserted-by":"crossref","unstructured":"Muthamil S, Kim HY, Jang HJ, Lyu JH, Shin UC, Go Y, et al. Biomarkers of cellular senescence and aging: current state-of-the-art, challenges and future perspectives. Adv Biol (Weinh). 2024:e2400079.","DOI":"10.1002\/adbi.202400079"},{"issue":"3","key":"2481_CR9","doi-asserted-by":"publisher","first-page":"312","DOI":"10.3171\/2023.10.SPINE23435","volume":"40","author":"MM Safaee","year":"2024","unstructured":"Safaee MM, Dwaraka VB, Lee JM, Fury M, Mendez TL, Smith R, et al. Epigenetic age biomarkers and risk assessment in adult spinal deformity: a novel association of biological age with frailty and disability. J Neurosurg Spine. 2024;40(3):312\u201323.","journal-title":"J Neurosurg Spine"},{"issue":"4","key":"2481_CR10","doi-asserted-by":"publisher","first-page":"381","DOI":"10.2106\/JBJS.23.01468","volume":"107","author":"SP Tarpada","year":"2025","unstructured":"Tarpada SP, Heid J, Sun S, Lee M, Maslov A, Vijg J, et al. Blood and bone-derived DNA methylation ages predict mortality after geriatric hip fracture: a pilot study. J Bone Joint Surg Am. 2025;107(4):381\u20138.","journal-title":"J Bone Joint Surg Am"},{"key":"2481_CR11","doi-asserted-by":"crossref","unstructured":"Klineberg EO, Wick JB, Lafage R, Lafage V, Pellise F, Haddad S, et al. Development and validation of a multidomain surgical complication classification system for adult spinal deformity. Spine (Phila Pa 1976). 2021;46(4):E267-E73.","DOI":"10.1097\/BRS.0000000000003766"},{"key":"2481_CR12","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2020.00190","volume":"8","author":"TC Sutherland","year":"2020","unstructured":"Sutherland TC, Geoffroy CG. The influence of neuron-extrinsic factors and aging on injury progression and axonal repair in the central nervous system. Front Cell Dev Biol. 2020;8:190.","journal-title":"Front Cell Dev Biol"},{"key":"2481_CR13","doi-asserted-by":"crossref","unstructured":"Kelly MP, Lovecchio FC, Klineberg EO, Smith JS, Line B, Gum JL, et al. Conflating disability, frailty, and multimorbidity in adult spinal deformity patients: seeking a continuous measure of vulnerability. Spine (Phila Pa 1976). 2026;51(5):343\u201353.","DOI":"10.1097\/BRS.0000000000005508"},{"issue":"3","key":"2481_CR14","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1093\/gerona\/glt138","volume":"69","author":"ME Levine","year":"2014","unstructured":"Levine ME. Response to Dr. Mitnitski\u2019s and Dr. Rockwood\u2019s letter to the editor: biological age revisited. J Gerontol A Biol Sci Med Sci. 2014;69(3):297\u20138.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"10","key":"2481_CR15","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1056\/NEJMra1601511","volume":"375","author":"SJ Pocock","year":"2016","unstructured":"Pocock SJ, Stone GW. The primary outcome is positive - is that good enough? N Engl J Med. 2016;375(10):971\u20139.","journal-title":"N Engl J Med"},{"issue":"6","key":"2481_CR16","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1007\/s43390-022-00524-6","volume":"10","author":"IR Turnbull","year":"2022","unstructured":"Turnbull IR, Hess A, Fuchs A, Frazier EP, Ghosh S, Hughes SW, et al. Cellular immunophenotype of major spine surgery in adults. Spine Deform. 2022;10(6):1375\u201384.","journal-title":"Spine Deform"}],"container-title":["GeroScience"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-026-02481-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11357-026-02481-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-026-02481-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:20:05Z","timestamp":1790140805000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11357-026-02481-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":16,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["2481"],"URL":"https:\/\/doi.org\/10.1007\/s11357-026-02481-8","relation":{},"ISSN":["2509-2723"],"issn-type":[{"value":"2509-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"assertion":[{"value":"19 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Dr. Kelly reported receiving nonfinancial support from AO Spine and personal fees from Wolters Kluwer outside the submitted work. Dr. Hills reports no conflicts of interest. Dr. Smith reported receiving grants from DePuy Synthes\/ISSGF during the conduct of the study; personal fees from Highridge, Globus\/NuVasive, Medtronic, Carlsmed, Cerapedics, and Orthofix\/SeaSpine; being a stock owner in Carlsmed, Alphatec, and Globus\/NuVasive; and receiving grants from Orthofix\/SeaSpine, the Neurosurgery Research & Education Foundation, and AO Spine, outside the submitted work. Dr. Lenke reported receiving grants from Scoliosis Spine Research, EOS, the Setting Scoliosis Straight Foundation, AOSpine, and the ISSG, receiving royalties and consulting fees from Medtronic, consulting fees from Abryx and Acuity Surgical, and nonfinancial support from Broadwater and the SRS for trips\/travel, outside the submitted work. Dr. Kim reported receiving personal fees from Zimmer Biomet, K2M\/Stryker, and Acuity Surgical, and grants from the ISSGF, outside the submitted work; having patents for NuVasive and Aspen Medical with royalties paid; and receiving payments to his institution from SI-BONE and AO Spine (fellowship support). Dr. Bess reported receiving grants from Medtronic, Globus, NuVasive, Stryker, Carlsmed, and the ISSGF, during the conduct of the study; and receiving grants from DePuy Synthes, SeaSpine, and the ISSGF, and personal fees from ATEC, outside the submitted work. B. Line reported receiving personal fees from the ISSG outside the submitted work. Dr. V. Lafage reported receiving consulting fees from Alphatec, Globus Medical, and Mainstay Medical; royalties from NuVasive; lecture fees from Johnson & Johnson, Stryker, and Implanet; being on the executive committee for the ISSG; and being a committee member for the Scoliosis Research Society (SRS), outside the submitted work. Mr. R. Lafage reported receiving personal fees from Carlsmed, outside the submitted work. Dr. Klineberg reported receiving consulting fees from DePuy Synthes, Medtronic, SeaSpine, SI-BONE, and Agnovos; consulting and royalty fees from Stryker Spine; having stock ownership in MMI and Relateable; receiving speaker fees from AO Spine North America (AONA Spine); chairing the board of directors for the International Meeting on Advanced Spine Techniques and AONA Spine; and being on the board of directors for the SRS, outside the submitted work. Dr. Pellis\u00e9 reports consulting fees from Medtronic and DePuy Spine. Dr. Kebaish reported receiving consulting fees from DePuy Synthes and royalties from Stryker, Orthofix, and SpineCraft, outside the submitted work. Dr. Gupta reported receiving royalties from Innomed; consultant, advisory, and travel fees from Medtronic; royalties and consultant and travel fees from Globus and DePuy; owning stock and receiving travel fees from SMAIO; owning stock in Johnson & Johnson; being on the board of directors of the Twentieth Century Orthopaedic Association; having travel expenses paid for by Broadwater; receiving honoraria and travel expenses from Yale; and receiving travel expenses from and being on the board of directors of the SRS, outside the submitted work. Dr. Schwab reported receiving personal fees from ZimVie, Medtronic, and Stryker, consulting fees from Mainstay Medical, royalties from MSD, being a noncompensated shareholder in VFT Solutions and SeaSpine, and being a noncompensated executive board member of the ISSG, outside the submitted work. Dr. Shaffrey reported receiving personal fees from Medtronic, NuVasive\/Globus, SI-BONE, and Proprio, outside the submitted work. Dr. Ames reported receiving royalties from DePuy Synthes, Zimmer Biomet Spine, K2M, Medicrea, Next Orthosurgical, NuVasive, and Stryker; consulting fees from DePuy Synthes, Medtronic, Medicrea, K2M, Agada Medical, and Carlsmed; research fees from Titan Spine, DePuy Synthes, and the ISSG; grants from the SRS; being on the editorial board of\n                      Operative Neurosurgery\n                      and\n                      Neurospine\n                      ; being on the executive committee of the ISSG; being chair of the SRS Safety and Value Committee; and being the director of Global Spinal Analytics, outside the submitted work. This work was supported by the ISSG Foundation which receives funding support from DePuy Synthes, K2M, NuVasive, Orthofix, and Zimmer Biomet.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}