{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T16:27:09Z","timestamp":1771864029117,"version":"3.50.1"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>It is becoming increasingly necessary for surgeons to provide evidence supporting cost-effectiveness of surgical treatment for cervical spine pathology. Anticipating surgical risk is critical in accurately evaluating the risk\/benefit balance of such treatment. Determining the risk and cost-effectiveness of surgery, complications, revision procedures, and mortality rates are the most significant limitations. The purpose of this study was to determine independent risk factors for medical complications (MCs), surgical complications (SCs), revisions, and mortality rates following surgery for patients with cervical spine pathology. The most relevant risk factors were used to structure an index that will help quantify risk and anticipate failure for such procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors of this study performed a retrospective review of the National Inpatient Sample (NIS) database for patients treated surgically for cervical spine pathology between 2001 and 2010. Multivariate models were performed to calculate the odds ratio (OR) of the independent risk factors that led to MCs and repeated for SCs, revisions, and mortality. The models controlled for age (&lt; and &gt; 65 years old), sex, race, revision status (except for revision analysis), surgical approach, number of levels fused\/re-fused (2\u20133, 4\u20138, \u2265 9), and osteotomy utilization. ORs were weighted based on their predictive category: 2 times for revision surgery predictors and 4 times for mortality predictors. Fifty points were distributed among the predictors based on their cumulative OR to establish a risk index.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Discharges for 362,989 patients with cervical spine pathology were identified. The mean age was 52.65 years, and 49.47% of patients were women. Independent risk factors included medical comorbidities, surgical parameters, and demographic factors. Medical comorbidities included the following: pulmonary circulation disorder, coagulopathy, metastatic cancer, renal failure, congestive heart failure, alcohol abuse, neurological disorder, nonmetastatic cancer, liver disease, rheumatoid arthritis\/collagen vascular diseases, and chronic blood loss\/anemia. Surgical parameters included posterior approach to fusion\/re-fusion, \u2265 9 levels fused\/re-fused, corpectomy, 4\u20138 levels fused\/re-fused, and osteotomy; demographic variables included age \u2265 65 years. These factors increased the risk of at least 1 of MC, SC, revision, or mortality (risk of death). A total of 50 points were distributed among the factors based on the cumulative risk ratio of every factor in proportion to the total risk ratios.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>This study proposed an index to quantify the potential risk of morbidity and mortality prior to surgical intervention for patients with cervical spine pathology. This index may be useful for surgeons in patient counseling efforts as well as for health insurance companies and future socioeconomics studies in assessing surgical risks and benefits for patients undergoing surgical treatment of the cervical spine.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.3.spine16887","type":"journal-article","created":{"date-parts":[[2017,8,25]],"date-time":"2017-08-25T14:02:20Z","timestamp":1503669740000},"page":"501-507","source":"Crossref","is-referenced-by-count":13,"title":["A novel index for quantifying the risk of early complications for patients undergoing cervical spine surgeries"],"prefix":"10.3171","volume":"27","author":[{"given":"Peter G.","family":"Passias","sequence":"first","affiliation":[{"name":"Division of Spine Surgery, Department of Neurological and Orthopaedic Surgery, NYU Langone Medical Center, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bassel G.","family":"Diebo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan J.","family":"Marascalchi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyrus M.","family":"Jalai","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Neurological and Orthopaedic Surgery, NYU Langone Medical Center, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha R.","family":"Horn","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Neurological and Orthopaedic Surgery, NYU Langone Medical Center, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter L.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Neurological and Orthopaedic Surgery, NYU Langone Medical Center, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Paltoo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia J.","family":"Bono","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Neurological and Orthopaedic Surgery, NYU Langone Medical Center, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Worley","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Neurological and Orthopaedic Surgery, NYU Langone Medical Center, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory W.","family":"Poorman","sequence":"additional","affiliation":[{"name":"Division of Spine Surgery, Department of Neurological and Orthopaedic Surgery, NYU Langone Medical Center, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Challier","sequence":"additional","affiliation":[{"name":"Spine Unit 1, Orthopedic Surgery Department, Bordeaux University Hospital, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anant","family":"Dixit","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Paulino","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, State University of New York, Downstate Medical Center, Brooklyn;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1097\/BRS.0000000000000729","article-title":"The association between insurance status and complications, length of stay, and costs for pediatric idiopathic scoliosis","volume":"40","author":"Cho SK","year":"2015","unstructured":"Cho SK, Egorova NN: The association between insurance status and complications, length of stay, and costs for pediatric idiopathic scoliosis. 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