{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:21:55Z","timestamp":1788823315840,"version":"build-2803163510"},"reference-count":47,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"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":["Global Spine Journal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective Cohort Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The purpose of this study was to identify the role of lumbar paraspinal muscle fatty infiltration using the Goutallier classification in predicting perioperative outcomes following elective lumbar surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted on patients who underwent elective one- or two-level lumbar decompressions or instrumented fusions for degenerative pathology at a single institution over a 3\u00a0year period. Patients were stratified by procedure type. Data included demographics, perioperative outcomes, and the 5-item Modified Frailty Index (MFI-5). Fatty infiltration was graded at L4-5 using the Goutallier classification (intraclass correlation coefficient = 0.908). Opportunistic osteoporosis screening used computed tomography-based Hounsfield units (HU) at L1-2. The relationships between Goutallier grade, demographics, MFI-5 score, and postoperative outcomes were analyzed using Chi-squared analyses, Fisher\u2019s exact test, Analysis of Variance, and multivariable logistic and linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 314 patients met the inclusion criteria. Mean age was 68.9 \u00b1 8.6\u00a0years; mean Goutallier score was 2.2 \u00b1 1.1 and MFI-5 was 1.3 \u00b1 1.0. Goutallier score significantly correlated with age, American Society of Anesthesiologists grade, steroid use, MFI-5, discharge disposition, and 180\u00a0day complications and reoperation. Subgroup analyses revealed differing associations between Goutallier score and comorbidities\/outcomes across procedure types. Multivariable regression confirmed Goutallier score as predictive of 180\u00a0day complications, reoperation, non-home discharge, and frailty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Goutallier score is a predictive marker of frailty and postoperative outcomes in lumbar spine surgery. Goutallier classification is an effective tool that can aid in risk stratification for patients undergoing lumbar spinal surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251359536","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T01:29:25Z","timestamp":1752110965000},"page":"884-894","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Extent of Fatty Infiltration of Lumbar Paraspinal Muscles as a Proxy for Frailty and Its Relationship with Perioperative Outcomes in Patients Undergoing Elective Spinal Surgery"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-4691","authenticated-orcid":false,"given":"Ronit","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Medical University of South 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