{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:55:48Z","timestamp":1781870148261,"version":"3.54.5"},"reference-count":35,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine whether preoperative EMG severity predicts clinically meaningful recovery after adult spinal deformity surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center observational cohort, prospectively collected data from 84 patients undergoing adult spinal deformity surgery were retrospectively analyzed. EMG radiculopathy severity was graded 1\u20133; grade 3 defined severe abnormality. 24-month ODI and VAS-leg improvement, MCID achievement, satisfaction, complications, and reoperations were compared. Regression models adjusted for baseline score, age, and fused levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ODI improved by 16.20 points and VAS-leg by 3.38 points overall; however, only 51.2% achieved ODI MCID. Severe EMG patients had less ODI improvement (9.09 vs 17.62 points; difference, 8.53; 95% CI, 4.23\u201312.84) and less VAS-leg improvement (1.15 vs 3.82 points; difference, 2.67; 95% CI, 1.83\u20133.52). Increasing EMG severity independently predicted less improvement and higher ODI MCID failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Major adult spinal deformity surgery improved average patient-reported outcomes; however, severe preoperative EMG abnormality identified a distinct high-risk, low-benefit phenotype in whom surgery was less likely to produce clinically meaningful radicular pain relief and more likely to be followed by poor satisfaction, complications, and reoperation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261462605","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:10:20Z","timestamp":1781709020000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The nerve-first paradigm: Preoperative EMG severity as a prognostic marker of clinically meaningful recovery after adult spinal deformity surgery"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2766-5083","authenticated-orcid":false,"given":"Vugar","family":"Nabi","sequence":"first","affiliation":[{"name":"University of Health Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Duygun","sequence":"additional","affiliation":[{"name":"University of Health Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aydogan","family":"Askin","sequence":"additional","affiliation":[{"name":"University of Health Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suleyman","family":"Avci","sequence":"additional","affiliation":[{"name":"University of Health Science"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2022.3.SPINE2295"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.3171\/2021.3.SPINE202140"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001636"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.14444\/8018"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2007.11.006"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.3171\/2012.1.SPINE11842"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2018.0077"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.1.000013"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2012.08.011"},{"key":"e_1_3_6_11_2","volume-title":"StatPearls","author":"Patel P","year":"2026","unstructured":"Patel P, Sohal A. 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Psychometric evaluation of the SF-36 health survey in Medicare managed care. Health Care Financ Rev 2004; 25: 5\u201325.","journal-title":"Health Care Financ Rev"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197153050-00004"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2022.0351"},{"key":"e_1_3_6_20_2","volume-title":"StatPearls","author":"Tamarkin RG","year":"2026","unstructured":"Tamarkin RG, Isaacson AC. Electrodiagnostic evaluation of lumbosacral radiculopathy (archived). In: StatPearls. StatPearls Publishing LLC., 2026. Treasure Island (FL) ineligible companies. 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