{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T21:46:08Z","timestamp":1782337568536,"version":"3.54.5"},"reference-count":41,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["World Neurosurgery"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.wneu.2026.125033","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T23:33:01Z","timestamp":1778196781000},"page":"125033","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["The Impact of Frailty on Mechanical Complications Following Lumbar Fusion Surgery: A Propensity Score-matched Analysis"],"prefix":"10.1016","volume":"211","author":[{"given":"Tao","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shibao","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.wneu.2026.125033_bib1","doi-asserted-by":"crossref","first-page":"348","DOI":"10.3171\/2024.9.SPINE24858","article-title":"The recovery trajectory of patient-reported outcomes in elderly patients with frailty undergoing lumbar spine fusion: a propensity score\u2013matching analysis","volume":"42","author":"Cui","year":"2025","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib2","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1177\/2192568218770769","article-title":"Degenerative lumbar spine disease: estimating global incidence and worldwide volume","volume":"8","author":"Ravindra","year":"2018","journal-title":"Glob Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib3","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.1227\/NEU.0000000000000950","article-title":"Berven PS the burden of spinal disorders in the elderly","volume":"77","author":"Waldrop","year":"2015","journal-title":"Neurosurgery"},{"key":"10.1016\/j.wneu.2026.125033_bib4","doi-asserted-by":"crossref","DOI":"10.1016\/j.wneu.2025.124351","article-title":"Higher improvement in oswestry disability index is appropriate to increase satisfaction of frail patients after lumbar fusion surgery","volume":"202","author":"Zhang","year":"2025","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.125033_bib5","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1007\/s00586-025-08684-5","article-title":"Lumbar spine fusion in elderly patients: risk factors for failure in achieving favorable outcomes","volume":"34","author":"Cui","year":"2025","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib6","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1177\/21925682231196828","article-title":"The 5-Factor modified frailty index is associated with increased risk of reoperations and adjacent level disease following single-level transforaminal lumbar interbody fusion","volume":"15","author":"Patel","year":"2023","journal-title":"Glob Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib7","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1016\/j.spinee.2025.01.015","article-title":"Diebo BG and Daniels AH revision surgery rates following transforaminal lumbar interbody fusion in patients with and without osteoporosis","volume":"25","author":"Knebel","year":"2025","journal-title":"Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib8","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1177\/21925682221124101","article-title":"Lee Y-P utility of the modified 5-Items frailty index to predict complications and mortality after elective cervical, thoracic and lumbar posterior spine fusion surgery: multicentric analysis from ACS-NSQIP database","volume":"14","author":"Camino-Willhuber","year":"2022","journal-title":"Glob Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib9","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1097\/BRS.0000000000004384","article-title":"Frailty and sarcopenia: impact on outcomes following elective degenerative lumbar spine surgery","volume":"47","author":"Chotai","year":"2022","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib10","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.2147\/CIA.S378327","article-title":"The impact of frailty on perioperative outcomes in patients receiving short-level posterior lumbar interbody fusion: a stepwise propensity score matching analysis","volume":"17","author":"Cui","year":"2022","journal-title":"Clin Interv Aging"},{"key":"10.1016\/j.wneu.2026.125033_bib11","doi-asserted-by":"crossref","first-page":"4785","DOI":"10.1097\/JS9.0000000000001594","article-title":"The impact of frailty on clinical outcomes of older patients undergoing enhanced recovery after lumbar fusion surgery: a prospective cohort study","volume":"110","author":"Wang","year":"2024","journal-title":"Int J Surg"},{"key":"10.1016\/j.wneu.2026.125033_bib12","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1097\/BRS.0000000000002596","article-title":"Impact of frailty and comorbidities on surgical outcomes and complications in adult spinal disorders","volume":"43","author":"Yagi","year":"2018","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib13","doi-asserted-by":"crossref","first-page":"163","DOI":"10.3171\/2020.11.SPINE201263","article-title":"The modified frailty index and patient outcomes following transforaminal lumbar interbody fusion surgery for single-level degenerative spine disease","volume":"35","author":"Moses","year":"2021","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib14","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s00586-024-08567-1","article-title":"Cargeli A and Faldini C the use of the psoas-to-lumbar vertebrae index and modified frailty index in predicting postoperative complications in degenerative spine surgery: can sarcopenia or frailty be underestimated?","volume":"34","author":"Ruffilli","year":"2024","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib15","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1186\/s13018-025-06078-3","article-title":"Modified frailty index predicts postoperative outcomes of Chinese elderly patients undergoing transforaminal lumbar interbody fusion","volume":"20","author":"Ma","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.wneu.2026.125033_bib16","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1016\/j.spinee.2024.05.010","article-title":"Paraspinal muscle endurance and morphology (PMEM) score: a new method for prediction of postoperative mechanical complications after lumbar fusion","volume":"24","author":"Han","year":"2024","journal-title":"Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib17","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1097\/BRS.0000000000003336","article-title":"The effect of paraspinal muscle degeneration on distal pedicle screw loosening following corrective surgery for degenerative lumbar scoliosis","volume":"45","author":"Leng","year":"2020","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib18","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1302\/0301-620X.102B12.BJJ-2020-0874.R1","article-title":"Predicting postoperative complications in patients undergoing lumbar spinal fusion by using the modified five-item frailty index and nutritional status","volume":"102-B","author":"Kang","year":"2020","journal-title":"Bone Joint J"},{"key":"10.1016\/j.wneu.2026.125033_bib19","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1097\/BRS.0000000000005043","article-title":"Lumbar apex position as an independent risk factor for adjacent segment diseases in patients undergoing short-level transforaminal lumbar interbody fusion","volume":"49","author":"Wang","year":"2024","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib20","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1097\/BRS.0000000000004260","article-title":"The modified 11-Item frailty index and postoperative outcomes in patients undergoing lateral lumbar interbody fusion","volume":"47","author":"Jung","year":"2022","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib21","doi-asserted-by":"crossref","first-page":"589","DOI":"10.3171\/2024.11.SPINE24869","article-title":"The predictive value of the fried frailty phenotype in evaluating postoperative outcomes in lumbar spine fusion surgery","volume":"42","author":"Mohamed","year":"2025","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib22","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s00586-018-5710-1","article-title":"The prevalence and impact of frailty in patients with symptomatic lumbar spinal stenosis","volume":"28","author":"Kim","year":"2018","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib23","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","article-title":"Frailty: implications for clinical practice and public health","volume":"394","author":"Hoogendijk","year":"2019","journal-title":"Lancet"},{"key":"10.1016\/j.wneu.2026.125033_bib24","doi-asserted-by":"crossref","first-page":"e80","DOI":"10.1016\/j.wneu.2024.05.167","article-title":"Predictive value of modified frailty index, sarcopenia, prognostic nutritional index, and geriatric nutritional risk index for postoperative complications in oblique lumbar interbody fusion over 60 years","volume":"189","author":"Kim","year":"2024","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.125033_bib25","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.spinee.2024.10.004","article-title":"Frailty and malnutrition as predictors of major complications following posterior thoracolumbar fusion in elderly patients: a retrospective cohort study","volume":"25","author":"Han","year":"2025","journal-title":"Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib26","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1007\/s00586-023-07945-5","article-title":"Comprehensive geriatric assessment to predict adverse events in elderly patients undergoing posterior lumbar fusion surgery","volume":"33","author":"Cui","year":"2023","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib27","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1177\/21925682221117139","article-title":"Posterior instrumented spinal surgery outcomes in the elderly: a comparison of the 5-Item and 11-Item modified frailty indices","volume":"14","author":"Kweh","year":"2022","journal-title":"Glob Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib28","doi-asserted-by":"crossref","first-page":"136","DOI":"10.3171\/2023.2.SPINE221019","article-title":"Comparison of the risk analysis index and the modified 5-factor frailty index in predicting 30-day morbidity and mortality after spine surgery","volume":"39","author":"Bowers","year":"2023","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib29","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/j.wneu.2023.08.027","volume":"180","author":"Kassicieh","year":"2023","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.125033_bib30","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1007\/s00586-025-09159-3","article-title":"The characterization of frailty in spine surgery: a systematic review of frailty indices","volume":"35","author":"Yu","year":"2025","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib31","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1007\/s43390-022-00476-x","article-title":"Is frailty responsive to surgical correction of adult spinal deformity? An investigation of sagittal re-alignment and frailty component drivers of postoperative frailty status","volume":"10","author":"Passias","year":"2022","journal-title":"Spine Deformity"},{"key":"10.1016\/j.wneu.2026.125033_bib32","doi-asserted-by":"crossref","first-page":"e759","DOI":"10.1016\/j.wneu.2020.03.071","article-title":"Kim CO and Ha Y association of frailty and self-care activity with sagittal spinopelvic alignment in the elderly","volume":"138","author":"Kim","year":"2020","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.125033_bib33","doi-asserted-by":"crossref","first-page":"646","DOI":"10.3171\/2023.5.SPINE23456","article-title":"Renaud Lafage and Schoenfeld AJ should realignment goals vary based on patient frailty status in adult spinal deformity?","volume":"39","author":"Passias","year":"2023","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib34","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1227\/neu.0000000000002091","article-title":"Ames CP and Smith JS highest achievable outcomes for patients undergoing cervical deformity corrective surgery by frailty","volume":"91","author":"Passias","year":"2022","journal-title":"Neurosurgery"},{"key":"10.1016\/j.wneu.2026.125033_bib35","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.spinee.2010.09.026","article-title":"Incidence and prevalence of surgery at segments adjacent to a previous posterior lumbar arthrodesis","volume":"11","author":"Sears","year":"2011","journal-title":"The Spine J"},{"key":"10.1016\/j.wneu.2026.125033_bib36","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.2106\/00004623-200407000-00020","article-title":"Adjacent segment degeneration in the lumbar spine","volume":"86","author":"Ghiselli","year":"2004","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.wneu.2026.125033_bib37","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1097\/BRS.0b013e31814b2d8e","article-title":"Yongjung Kim and Baldus C adjacent segment disease following lumbar\/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up","volume":"32","author":"Cheh","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.wneu.2026.125033_bib38","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1227\/NEU.0000000000000627","article-title":"Huang Y-H impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease","volume":"76","author":"Ou","year":"2015","journal-title":"Neurosurgery"},{"key":"10.1016\/j.wneu.2026.125033_bib39","doi-asserted-by":"crossref","first-page":"114","DOI":"10.11005\/jbm.2024.31.2.114","article-title":"Systematic review and meta-analysis of the effect of osteoporosis on reoperation rates and complications after surgical management of lumbar degenerative disease","volume":"31","author":"Lechtholz-Zey","year":"2024","journal-title":"J Bone Metab"},{"key":"10.1016\/j.wneu.2026.125033_bib40","doi-asserted-by":"crossref","first-page":"E1588","DOI":"10.1097\/BRS.0000000000003682","article-title":"Effects of restoration of sagittal alignment on adjacent segment degeneration in instrumented lumbar fusions","volume":"45","author":"Kim","year":"2020","journal-title":"Spine"},{"key":"10.1016\/j.wneu.2026.125033_bib41","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.spinee.2024.09.019","article-title":"Long-term mechanical failure in well aligned adult spinal deformity patients","volume":"25","author":"Haddad","year":"2025","journal-title":"Spine J"}],"container-title":["World Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875026002494?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875026002494?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T20:46:38Z","timestamp":1782333998000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1878875026002494"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":41,"alternative-id":["S1878875026002494"],"URL":"https:\/\/doi.org\/10.1016\/j.wneu.2026.125033","relation":{},"ISSN":["1878-8750"],"issn-type":[{"value":"1878-8750","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Impact of Frailty on Mechanical Complications Following Lumbar Fusion Surgery: A Propensity Score-matched Analysis","name":"articletitle","label":"Article Title"},{"value":"World Neurosurgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.wneu.2026.125033","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"125033"}}