{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:44:45Z","timestamp":1794019485219,"version":"4.8.0"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate the effect of Enhanced Recovery After Surgery plus preoperative antifrailty (PAFERAS) on surgical outcomes of frail patients who underwent long-segment surgery for adult spinal deformity (ASD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This is a retrospective study using a prospectively collected ASD database. Patients who underwent open long-segment fusion surgery (\u2265 5 levels) for ASD between January 2017 and March 2024 were classified as nonfrail (NF; 5-factor modified frailty index [mFI-5] score = 0), prefrail (PF; mFI-5 score = 1), or frail (mFI-5 score \u2265 2) based on their physical activity and comorbidities. For frail patients, the antifrailty interventions of the PAFERAS program focused on preoperative exercise and nutritional optimization. NF\/PF patients of the PAFERAS group received preoperative dietary counseling, nutritional education, and standardized rehabilitation advice. Meanwhile, frail patients were divided into non-PAFERAS (before January 2019) and PAFERAS (after January 2019) groups based on whether they received PAFERAS care or not. Frail patients with antifrailty (AF group) were compared with PF patients, NF patients, and frail patients in the non-PAFERAS group. AF patients were propensity score matched 1:1 to the NF, PF, and non-PAFERAS groups patients based on age, pelvic incidence minus lumbar lordosis, and intraoperative estimated blood loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 286 patients from the PAFERAS group (31.8% in the NF group, 46.9% in the PF group, and 21.3% in the AF group) and 142 patients from the non-PAFERAS group were included in the final analysis. The 1st day of assisted walking occurred, on average, 1 day earlier in the AF group than in frail patients from the non-PAFERAS group (3.52 vs 2.54 days, p = 0.016). The postoperative length of hospital stay (LOS) for frail patients significantly decreased from 14.29 days before PAFERAS to 10.64 days after PAFERAS (p = 0.011). No significant differences were observed between the matched AF and NF\/PF groups in the 1st day of assisted walking and the 1st day of bowel movement. There were no differences between the AF and NF\/PF groups in postoperative LOS, nonhome discharge rate, rates of severe complications, and rates of minor complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The PAFERAS protocol significantly improves the return of physiological function and the LOS for frail patients undergoing ASD surgery. After implementing preoperative exercise and nutritional optimization for frail patients, the recovery process of physiological function and LOS in patients with frailty were similar to those in NF or PF patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.1.spine241372","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T22:21:49Z","timestamp":1745619709000},"page":"405-415","source":"Crossref","is-referenced-by-count":4,"title":["Enhanced Recovery After Surgery plus preoperative antifrailty in frail patients with adult spinal deformity: a two-step propensity score\u2013matched analysis"],"prefix":"10.3171","volume":"43","author":[{"given":"Shuaikang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopedics & Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing; and"},{"name":"Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics & Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing; and"},{"name":"Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopedics & Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing; and"},{"name":"Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics & Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing; and"},{"name":"Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics & Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing; and"},{"name":"Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shibao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics & Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing; and"},{"name":"Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10193","key":"b1","series-title":"Lancet","first-page":"160","article-title":"Adult spinal deformity","volume":"394","author":"Diebo BG","year":"2019","unstructured":"Diebo BG, Shah NV, Boachie-Adjei O,  Adult spinal deformity. Lancet. 2019;394(10193):160\u2013172."},{"issue":"9","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"1082","article-title":"Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population","volume":"30","author":"Schwab F","year":"2005","unstructured":"Schwab F, Dubey A, Gamez L,  Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976). 2005;30(9):1082\u20131085."},{"issue":"5","key":"b3","series-title":"Spine Deform","first-page":"342","article-title":"Adult spinal deformity: national trends in the presentation, treatment, and perioperative outcomes from 2003 to 2010","volume":"5","author":"Passias PG","year":"2017","unstructured":"Passias PG, Jalai CM, Worley N,  Adult spinal deformity: national trends in the presentation, treatment, and perioperative outcomes from 2003 to 2010. Spine Deform. 2017;5(5):342\u2013350."},{"issue":"8","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"536","article-title":"Comparison of four nutritional screening tools for predicting postoperative adverse events following degenerative spinal deformity surgery","volume":"49","author":"Wang SK","year":"2024","unstructured":"Wang SK, Li J, Wang P,  Comparison of four nutritional screening tools for predicting postoperative adverse events following degenerative spinal deformity surgery. Spine (Phila Pa 1976). 2024;49(8):536\u2013546."},{"issue":"4","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"E267","article-title":"Development and validation of a multidomain surgical complication classification system for adult spinal deformity","volume":"46","author":"Klineberg EO","year":"2021","unstructured":"Klineberg EO, Wick JB, Lafage R,  Development and validation of a multidomain surgical complication classification system for adult spinal deformity. Spine (Phila Pa 1976). 2021;46(4):E267\u2013E273."},{"issue":"10","key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"817","article-title":"Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age","volume":"36","author":"Smith JS","year":"2011","unstructured":"Smith JS, Shaffrey CI, Glassman SD,  Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age. Spine (Phila Pa 1976). 2011;36(10):817\u2013824."},{"issue":"22","key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"1718","article-title":"Medical complications after adult spinal deformity surgery: incidence, risk factors, and clinical impact","volume":"41","author":"Soroceanu A","year":"2016","unstructured":"Soroceanu A, Burton DC, Oren JH,  Medical complications after adult spinal deformity surgery: incidence, risk factors, and clinical impact. Spine (Phila Pa 1976). 2016;41(22):1718\u20131723."},{"issue":"18","key":"b8","series-title":"Spine (Phila Pa 1976)","first-page":"1259","article-title":"Impact of frailty and comorbidities on surgical outcomes and complications in adult spinal disorders","volume":"43","author":"Yagi M","year":"2018","unstructured":"Yagi M, Fujita N, Okada E,  Impact of frailty and comorbidities on surgical outcomes and complications in adult spinal disorders. Spine (Phila Pa 1976). 2018;43(18):1259\u20131267."},{"key":"b9","series-title":"J Clin Neurosci","first-page":"69","article-title":"The 5-factor modified frailty index (mFI-5) is predictive of 30-day postoperative complications and readmission in patients with adult spinal deformity (ASD)","volume":"104","author":"Shah NV","year":"2022","unstructured":"Shah NV, Kim DJ, Patel N,  The 5-factor modified frailty index (mFI-5) is predictive of 30-day postoperative complications and readmission in patients with adult spinal deformity (ASD). J Clin Neurosci. 2022;104:69\u201373."},{"issue":"2","key":"b10","series-title":"Spine J","first-page":"325","article-title":"Predicting major complications and discharge disposition after adult spinal deformity surgery","volume":"24","author":"Vadhera AS","year":"2024","unstructured":"Vadhera AS, Sachdev R, Andrade NS,  Predicting major complications and discharge disposition after adult spinal deformity surgery. Spine J. 2024;24(2):325\u2013329."},{"issue":"5","key":"b11","series-title":"Spine J","first-page":"746","article-title":"Preoperative characteristics are associated with increased likelihood of low early postoperative mobility after adult spinal deformity surgery","volume":"23","author":"Schmerler J","year":"2023","unstructured":"Schmerler J, Mo KC, Olson J,  Preoperative characteristics are associated with increased likelihood of low early postoperative mobility after adult spinal deformity surgery. Spine J. 2023;23(5):746\u2013753."},{"issue":"10206","key":"b12","series-title":"Lancet","first-page":"1365","article-title":"Frailty: implications for clinical practice and public health","volume":"394","author":"Hoogendijk EO","year":"2019","unstructured":"Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health. Lancet. 2019;394(10206):1365\u20131375."},{"issue":"2","key":"b13","series-title":"Age Ageing","first-page":"193","article-title":"Frailty index as a predictor of mortality: a systematic review and meta-analysis","volume":"47","author":"Kojima G","year":"2018","unstructured":"Kojima G, Iliffe S, Walters K. Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing. 2018;47(2):193\u2013200."},{"issue":"5","key":"b14","series-title":"Spine Deform","first-page":"1189","article-title":"The 5-item modified frailty index predicts spinal osteotomy outcomes better than age in adult spinal deformity patients: an ACS - NSQIP analysis","volume":"11","author":"Tarawneh OH","year":"2023","unstructured":"Tarawneh OH, Vellek J, Kazim SF,  The 5-item modified frailty index predicts spinal osteotomy outcomes better than age in adult spinal deformity patients: an ACS - NSQIP analysis. Spine Deform. 2023;11(5):1189\u20131197."},{"issue":"7","key":"b15","series-title":"Clin Spine Surg","first-page":"E377","article-title":"Frailty severity impacts development of hospital-acquired conditions in patients undergoing corrective surgery for adult spinal deformity","volume":"34","author":"Pierce KE","year":"2021","unstructured":"Pierce KE, Kapadia BH, Bortz C,  Frailty severity impacts development of hospital-acquired conditions in patients undergoing corrective surgery for adult spinal deformity. Clin Spine Surg. 2021;34(7):E377\u2013E381."},{"issue":"9","key":"b16","series-title":"Spine J","first-page":"1559","article-title":"Predictors of serious, preventable, and costly medical complications in a population of adult spinal deformity patients","volume":"21","author":"Alas H","year":"2021","unstructured":"Alas H, Passias PG, Brown AE,  Predictors of serious, preventable, and costly medical complications in a population of adult spinal deformity patients. Spine J. 2021;21(9):1559\u20131566."},{"issue":"4","key":"b17","series-title":"JAMA Netw Open","first-page":"e238050","article-title":"Prehabilitation for patients undergoing orthopedic surgery: a systematic review and meta-analysis","volume":"6","author":"Punnoose A","year":"2023","unstructured":"Punnoose A, Claydon-Mueller LS, Weiss O, Zhang J, Rushton A, Khanduja V. Prehabilitation for patients undergoing orthopedic surgery: a systematic review and meta-analysis. JAMA Netw Open. 2023;6(4):e238050."},{"issue":"5","key":"b18","series-title":"Cochrane Database Syst Rev","first-page":"CD013259","article-title":"Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery","volume":"5","author":"Molenaar CJ","year":"2022","unstructured":"Molenaar CJ, van Rooijen SJ, Fokkenrood HJ, Roumen RM, Janssen L, Slooter GD. Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery. Cochrane Database Syst Rev. 2022;5(5):CD013259."},{"issue":"2","key":"b19","series-title":"Ann Surg","first-page":"e299","article-title":"Effects of community-based exercise prehabilitation for patients scheduled for colorectal surgery with high risk for postoperative complications: results of a randomized clinical trial","volume":"275","author":"Berkel AEM","year":"2022","unstructured":"Berkel AEM, Bongers BC, Kotte H,  Effects of community-based exercise prehabilitation for patients scheduled for colorectal surgery with high risk for postoperative complications: results of a randomized clinical trial. Ann Surg. 2022;275(2):e299\u2013e306."},{"issue":"5","key":"b20","series-title":"Spine (Phila Pa 1976)","first-page":"304","article-title":"Preoperative optimization for adult spinal deformity surgery: a systematic review","volume":"49","author":"Katiyar P","year":"2024","unstructured":"Katiyar P, Reyes J, Coury J, Lombardi J, Sardar Z. Preoperative optimization for adult spinal deformity surgery: a systematic review. Spine (Phila Pa 1976). 2024;49(5):304\u2013312."},{"issue":"1","key":"b21","series-title":"BMC Musculoskelet Disord","first-page":"29","article-title":"The implementation of enhanced recovery after surgery pathway in patients undergoing posterior thoracolumbar fusion for degenerative spinal deformity","volume":"24","author":"Yuan Y","year":"2023","unstructured":"Yuan Y, Wang SK, Chai XY,  The implementation of enhanced recovery after surgery pathway in patients undergoing posterior thoracolumbar fusion for degenerative spinal deformity. BMC Musculoskelet Disord. 2023;24(1):29\u201336."},{"issue":"12","key":"b22","series-title":"Age Ageing","first-page":"afad227","article-title":"Mobile applications to prescribe physical exercise in frail older adults: review of the available tools in app stores","volume":"52","author":"Soto-Bagaria L","year":"2023","unstructured":"Soto-Bagaria L, Eis S, P\u00e9rez LM,  Mobile applications to prescribe physical exercise in frail older adults: review of the available tools in app stores. Age Ageing. 2023;52(12):afad227."},{"issue":"2","key":"b23","series-title":"J Cachexia Sarcopenia Muscle","first-page":"884","article-title":"Effects of Vivifrail multicomponent intervention on functional capacity: a multicentre, randomized controlled trial","volume":"13","author":"Casas-Herrero \u00c1","year":"2022","unstructured":"Casas-Herrero \u00c1, S\u00e1ez de Asteasu ML, Ant\u00f3n-Rodrigo I,  Effects of Vivifrail multicomponent intervention on functional capacity: a multicentre, randomized controlled trial. J Cachexia Sarcopenia Muscle. 2022;13(2):884\u2013893."},{"issue":"2","key":"b24","series-title":"Ann Surg","first-page":"187","article-title":"The Clavien-Dindo classification of surgical complications: five-year experience","volume":"250","author":"Clavien PA","year":"2009","unstructured":"Clavien PA, Barkun J, de Oliveira ML,  The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187\u2013196."},{"issue":"6","key":"b25","series-title":"J Patient Saf","first-page":"e900","article-title":"National Surgical Quality Improvement Program adverse events combined with Clavien-Dindo scores can direct quality improvement processes in surgical patients","volume":"18","author":"Ghannam AD","year":"2022","unstructured":"Ghannam AD, Crandall ML, Woodruff G,  National Surgical Quality Improvement Program adverse events combined with Clavien-Dindo scores can direct quality improvement processes in surgical patients. J Patient Saf. 2022;18(6):e900\u2013e902."},{"issue":"7","key":"b26","series-title":"Spine J","first-page":"1191","article-title":"Which frailty scales for patients with adult spinal deformity are feasible and adequate? A systematic review","volume":"22","author":"Kitamura K","year":"2022","unstructured":"Kitamura K, van Hooff M, Jacobs W, Watanabe K, de Kleuver M. Which frailty scales for patients with adult spinal deformity are feasible and adequate? A systematic review. Spine J. 2022;22(7):1191\u20131204."},{"issue":"1","key":"b27","series-title":"Eur Spine J","first-page":"46","article-title":"The prevalence and impact of frailty in patients with symptomatic lumbar spinal stenosis","volume":"28","author":"Kim HJ","year":"2019","unstructured":"Kim HJ, Park S, Park SH,  The prevalence and impact of frailty in patients with symptomatic lumbar spinal stenosis. Eur Spine J. 2019;28(1):46\u201354."},{"key":"b28","series-title":"World Neurosurg","first-page":"e759","article-title":"Association of frailty and self-care activity with sagittal spinopelvic alignment in the elderly","volume":"138","author":"Kim TW","year":"2020","unstructured":"Kim TW, Oh JK, Lee JY,  Association of frailty and self-care activity with sagittal spinopelvic alignment in the elderly. World Neurosurg. 2020;138:e759\u2013e766."},{"issue":"3","key":"b29","series-title":"Br J Anaesth","first-page":"434","article-title":"Prehabilitation, enhanced recovery after surgery, or both? A narrative review","volume":"128","author":"Gillis C","year":"2022","unstructured":"Gillis C, Ljungqvist O, Carli F. Prehabilitation, enhanced recovery after surgery, or both? A narrative review. Br J Anaesth. 2022;128(3):434\u2013448."},{"issue":"3","key":"b30","series-title":"J Orthop Sports Phys Ther","first-page":"103","article-title":"Current prehabilitation programs do not improve the postoperative outcomes of patients scheduled for lumbar spine surgery: a systematic review with meta-analysis","volume":"51","author":"Janssen ERC","year":"2021","unstructured":"Janssen ERC, Punt IM, Clemens MJ, Staal JB, Hoogeboom TJ, Willems PC. Current prehabilitation programs do not improve the postoperative outcomes of patients scheduled for lumbar spine surgery: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2021;51(3):103\u2013114."},{"issue":"2","key":"b31","series-title":"Spine J","first-page":"219","article-title":"Timing of inpatient medical complications after adult spinal deformity surgery: early ambulation matters","volume":"23","author":"Lovecchio F","year":"2023","unstructured":"Lovecchio F, Jordan Y, Punyala A,  Timing of inpatient medical complications after adult spinal deformity surgery: early ambulation matters. Spine J. 2023;23(2):219\u2013226."},{"key":"b32","series-title":"Clin Interv Aging","first-page":"1793","article-title":"Comparison of perioperative outcomes in patients undergoing short-level lumbar fusion surgery after implementing enhanced recovery after surgery: a propensity score matching analysis focusing on young-old and old-old","volume":"17","author":"Cui P","year":"2022","unstructured":"Cui P, Wang P, Hu X, Kong C, Lu S. Comparison of perioperative outcomes in patients undergoing short-level lumbar fusion surgery after implementing enhanced recovery after surgery: a propensity score matching analysis focusing on young-old and old-old. Clin Interv Aging. 2022;17:1793\u20131801."},{"issue":"10193","key":"b1","series-title":"Lancet","first-page":"160","article-title":"Adult spinal deformity","volume":"394","author":"Diebo BG","year":"2019","unstructured":"Diebo BG, Shah NV, Boachie-Adjei O,  Adult spinal deformity. Lancet. 2019;394(10193):160\u2013172."},{"issue":"9","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"1082","article-title":"Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population","volume":"30","author":"Schwab F","year":"2005","unstructured":"Schwab F, Dubey A, Gamez L,  Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976). 2005;30(9):1082\u20131085."},{"issue":"5","key":"b3","series-title":"Spine Deform","first-page":"342","article-title":"Adult spinal deformity: national trends in the presentation, treatment, and perioperative outcomes from 2003 to 2010","volume":"5","author":"Passias PG","year":"2017","unstructured":"Passias PG, Jalai CM, Worley N,  Adult spinal deformity: national trends in the presentation, treatment, and perioperative outcomes from 2003 to 2010. Spine Deform. 2017;5(5):342\u2013350."},{"issue":"8","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"536","article-title":"Comparison of four nutritional screening tools for predicting postoperative adverse events following degenerative spinal deformity surgery","volume":"49","author":"Wang SK","year":"2024","unstructured":"Wang SK, Li J, Wang P,  Comparison of four nutritional screening tools for predicting postoperative adverse events following degenerative spinal deformity surgery. Spine (Phila Pa 1976). 2024;49(8):536\u2013546."},{"issue":"4","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"E267","article-title":"Development and validation of a multidomain surgical complication classification system for adult spinal deformity","volume":"46","author":"Klineberg EO","year":"2021","unstructured":"Klineberg EO, Wick JB, Lafage R,  Development and validation of a multidomain surgical complication classification system for adult spinal deformity. Spine (Phila Pa 1976). 2021;46(4):E267\u2013E273."},{"issue":"10","key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"817","article-title":"Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age","volume":"36","author":"Smith JS","year":"2011","unstructured":"Smith JS, Shaffrey CI, Glassman SD,  Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age. Spine (Phila Pa 1976). 2011;36(10):817\u2013824."},{"issue":"22","key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"1718","article-title":"Medical complications after adult spinal deformity surgery: incidence, risk factors, and clinical impact","volume":"41","author":"Soroceanu A","year":"2016","unstructured":"Soroceanu A, Burton DC, Oren JH,  Medical complications after adult spinal deformity surgery: incidence, risk factors, and clinical impact. Spine (Phila Pa 1976). 2016;41(22):1718\u20131723."},{"issue":"18","key":"b8","series-title":"Spine (Phila Pa 1976)","first-page":"1259","article-title":"Impact of frailty and comorbidities on surgical outcomes and complications in adult spinal disorders","volume":"43","author":"Yagi M","year":"2018","unstructured":"Yagi M, Fujita N, Okada E,  Impact of frailty and comorbidities on surgical outcomes and complications in adult spinal disorders. Spine (Phila Pa 1976). 2018;43(18):1259\u20131267."},{"key":"b9","series-title":"J Clin Neurosci","first-page":"69","article-title":"The 5-factor modified frailty index (mFI-5) is predictive of 30-day postoperative complications and readmission in patients with adult spinal deformity (ASD)","volume":"104","author":"Shah NV","year":"2022","unstructured":"Shah NV, Kim DJ, Patel N,  The 5-factor modified frailty index (mFI-5) is predictive of 30-day postoperative complications and readmission in patients with adult spinal deformity (ASD). J Clin Neurosci. 2022;104:69\u201373."},{"issue":"2","key":"b10","series-title":"Spine J","first-page":"325","article-title":"Predicting major complications and discharge disposition after adult spinal deformity surgery","volume":"24","author":"Vadhera AS","year":"2024","unstructured":"Vadhera AS, Sachdev R, Andrade NS,  Predicting major complications and discharge disposition after adult spinal deformity surgery. Spine J. 2024;24(2):325\u2013329."},{"issue":"5","key":"b11","series-title":"Spine J","first-page":"746","article-title":"Preoperative characteristics are associated with increased likelihood of low early postoperative mobility after adult spinal deformity surgery","volume":"23","author":"Schmerler J","year":"2023","unstructured":"Schmerler J, Mo KC, Olson J,  Preoperative characteristics are associated with increased likelihood of low early postoperative mobility after adult spinal deformity surgery. Spine J. 2023;23(5):746\u2013753."},{"issue":"10206","key":"b12","series-title":"Lancet","first-page":"1365","article-title":"Frailty: implications for clinical practice and public health","volume":"394","author":"Hoogendijk EO","year":"2019","unstructured":"Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health. Lancet. 2019;394(10206):1365\u20131375."},{"issue":"2","key":"b13","series-title":"Age Ageing","first-page":"193","article-title":"Frailty index as a predictor of mortality: a systematic review and meta-analysis","volume":"47","author":"Kojima G","year":"2018","unstructured":"Kojima G, Iliffe S, Walters K. Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing. 2018;47(2):193\u2013200."},{"issue":"5","key":"b14","series-title":"Spine Deform","first-page":"1189","article-title":"The 5-item modified frailty index predicts spinal osteotomy outcomes better than age in adult spinal deformity patients: an ACS - NSQIP analysis","volume":"11","author":"Tarawneh OH","year":"2023","unstructured":"Tarawneh OH, Vellek J, Kazim SF,  The 5-item modified frailty index predicts spinal osteotomy outcomes better than age in adult spinal deformity patients: an ACS - NSQIP analysis. Spine Deform. 2023;11(5):1189\u20131197."},{"issue":"7","key":"b15","series-title":"Clin Spine Surg","first-page":"E377","article-title":"Frailty severity impacts development of hospital-acquired conditions in patients undergoing corrective surgery for adult spinal deformity","volume":"34","author":"Pierce KE","year":"2021","unstructured":"Pierce KE, Kapadia BH, Bortz C,  Frailty severity impacts development of hospital-acquired conditions in patients undergoing corrective surgery for adult spinal deformity. Clin Spine Surg. 2021;34(7):E377\u2013E381."},{"issue":"9","key":"b16","series-title":"Spine J","first-page":"1559","article-title":"Predictors of serious, preventable, and costly medical complications in a population of adult spinal deformity patients","volume":"21","author":"Alas H","year":"2021","unstructured":"Alas H, Passias PG, Brown AE,  Predictors of serious, preventable, and costly medical complications in a population of adult spinal deformity patients. Spine J. 2021;21(9):1559\u20131566."},{"issue":"4","key":"b17","series-title":"JAMA Netw Open","first-page":"e238050","article-title":"Prehabilitation for patients undergoing orthopedic surgery: a systematic review and meta-analysis","volume":"6","author":"Punnoose A","year":"2023","unstructured":"Punnoose A, Claydon-Mueller LS, Weiss O, Zhang J, Rushton A, Khanduja V. Prehabilitation for patients undergoing orthopedic surgery: a systematic review and meta-analysis. JAMA Netw Open. 2023;6(4):e238050."},{"issue":"5","key":"b18","series-title":"Cochrane Database Syst Rev","first-page":"CD013259","article-title":"Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery","volume":"5","author":"Molenaar CJ","year":"2022","unstructured":"Molenaar CJ, van Rooijen SJ, Fokkenrood HJ, Roumen RM, Janssen L, Slooter GD. Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery. Cochrane Database Syst Rev. 2022;5(5):CD013259."},{"issue":"2","key":"b19","series-title":"Ann Surg","first-page":"e299","article-title":"Effects of community-based exercise prehabilitation for patients scheduled for colorectal surgery with high risk for postoperative complications: results of a randomized clinical trial","volume":"275","author":"Berkel AEM","year":"2022","unstructured":"Berkel AEM, Bongers BC, Kotte H,  Effects of community-based exercise prehabilitation for patients scheduled for colorectal surgery with high risk for postoperative complications: results of a randomized clinical trial. Ann Surg. 2022;275(2):e299\u2013e306."},{"issue":"5","key":"b20","series-title":"Spine (Phila Pa 1976)","first-page":"304","article-title":"Preoperative optimization for adult spinal deformity surgery: a systematic review","volume":"49","author":"Katiyar P","year":"2024","unstructured":"Katiyar P, Reyes J, Coury J, Lombardi J, Sardar Z. Preoperative optimization for adult spinal deformity surgery: a systematic review. Spine (Phila Pa 1976). 2024;49(5):304\u2013312."},{"issue":"1","key":"b21","series-title":"BMC Musculoskelet Disord","first-page":"29","article-title":"The implementation of enhanced recovery after surgery pathway in patients undergoing posterior thoracolumbar fusion for degenerative spinal deformity","volume":"24","author":"Yuan Y","year":"2023","unstructured":"Yuan Y, Wang SK, Chai XY,  The implementation of enhanced recovery after surgery pathway in patients undergoing posterior thoracolumbar fusion for degenerative spinal deformity. BMC Musculoskelet Disord. 2023;24(1):29\u201336."},{"issue":"12","key":"b22","series-title":"Age Ageing","first-page":"afad227","article-title":"Mobile applications to prescribe physical exercise in frail older adults: review of the available tools in app stores","volume":"52","author":"Soto-Bagaria L","year":"2023","unstructured":"Soto-Bagaria L, Eis S, P\u00e9rez LM,  Mobile applications to prescribe physical exercise in frail older adults: review of the available tools in app stores. Age Ageing. 2023;52(12):afad227."},{"issue":"2","key":"b23","series-title":"J Cachexia Sarcopenia Muscle","first-page":"884","article-title":"Effects of Vivifrail multicomponent intervention on functional capacity: a multicentre, randomized controlled trial","volume":"13","author":"Casas-Herrero \u00c1","year":"2022","unstructured":"Casas-Herrero \u00c1, S\u00e1ez de Asteasu ML, Ant\u00f3n-Rodrigo I,  Effects of Vivifrail multicomponent intervention on functional capacity: a multicentre, randomized controlled trial. J Cachexia Sarcopenia Muscle. 2022;13(2):884\u2013893."},{"issue":"2","key":"b24","series-title":"Ann Surg","first-page":"187","article-title":"The Clavien-Dindo classification of surgical complications: five-year experience","volume":"250","author":"Clavien PA","year":"2009","unstructured":"Clavien PA, Barkun J, de Oliveira ML,  The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187\u2013196."},{"issue":"6","key":"b25","series-title":"J Patient Saf","first-page":"e900","article-title":"National Surgical Quality Improvement Program adverse events combined with Clavien-Dindo scores can direct quality improvement processes in surgical patients","volume":"18","author":"Ghannam AD","year":"2022","unstructured":"Ghannam AD, Crandall ML, Woodruff G,  National Surgical Quality Improvement Program adverse events combined with Clavien-Dindo scores can direct quality improvement processes in surgical patients. J Patient Saf. 2022;18(6):e900\u2013e902."},{"issue":"7","key":"b26","series-title":"Spine J","first-page":"1191","article-title":"Which frailty scales for patients with adult spinal deformity are feasible and adequate? A systematic review","volume":"22","author":"Kitamura K","year":"2022","unstructured":"Kitamura K, van Hooff M, Jacobs W, Watanabe K, de Kleuver M. Which frailty scales for patients with adult spinal deformity are feasible and adequate? A systematic review. Spine J. 2022;22(7):1191\u20131204."},{"issue":"1","key":"b27","series-title":"Eur Spine J","first-page":"46","article-title":"The prevalence and impact of frailty in patients with symptomatic lumbar spinal stenosis","volume":"28","author":"Kim HJ","year":"2019","unstructured":"Kim HJ, Park S, Park SH,  The prevalence and impact of frailty in patients with symptomatic lumbar spinal stenosis. Eur Spine J. 2019;28(1):46\u201354."},{"key":"b28","series-title":"World Neurosurg","first-page":"e759","article-title":"Association of frailty and self-care activity with sagittal spinopelvic alignment in the elderly","volume":"138","author":"Kim TW","year":"2020","unstructured":"Kim TW, Oh JK, Lee JY,  Association of frailty and self-care activity with sagittal spinopelvic alignment in the elderly. World Neurosurg. 2020;138:e759\u2013e766."},{"issue":"3","key":"b29","series-title":"Br J Anaesth","first-page":"434","article-title":"Prehabilitation, enhanced recovery after surgery, or both? A narrative review","volume":"128","author":"Gillis C","year":"2022","unstructured":"Gillis C, Ljungqvist O, Carli F. Prehabilitation, enhanced recovery after surgery, or both? A narrative review. Br J Anaesth. 2022;128(3):434\u2013448."},{"issue":"3","key":"b30","series-title":"J Orthop Sports Phys Ther","first-page":"103","article-title":"Current prehabilitation programs do not improve the postoperative outcomes of patients scheduled for lumbar spine surgery: a systematic review with meta-analysis","volume":"51","author":"Janssen ERC","year":"2021","unstructured":"Janssen ERC, Punt IM, Clemens MJ, Staal JB, Hoogeboom TJ, Willems PC. Current prehabilitation programs do not improve the postoperative outcomes of patients scheduled for lumbar spine surgery: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2021;51(3):103\u2013114."},{"issue":"2","key":"b31","series-title":"Spine J","first-page":"219","article-title":"Timing of inpatient medical complications after adult spinal deformity surgery: early ambulation matters","volume":"23","author":"Lovecchio F","year":"2023","unstructured":"Lovecchio F, Jordan Y, Punyala A,  Timing of inpatient medical complications after adult spinal deformity surgery: early ambulation matters. Spine J. 2023;23(2):219\u2013226."},{"key":"b32","series-title":"Clin Interv Aging","first-page":"1793","article-title":"Comparison of perioperative outcomes in patients undergoing short-level lumbar fusion surgery after implementing enhanced recovery after surgery: a propensity score matching analysis focusing on young-old and old-old","volume":"17","author":"Cui P","year":"2022","unstructured":"Cui P, Wang P, Hu X, Kong C, Lu S. Comparison of perioperative outcomes in patients undergoing short-level lumbar fusion surgery after implementing enhanced recovery after surgery: a propensity score matching analysis focusing on young-old and old-old. Clin Interv Aging. 2022;17:1793\u20131801."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/43\/4\/article-p405.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/43\/4\/article-p405.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/43\/4\/article-p405.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:45:13Z","timestamp":1772804713000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/43\/4\/article-p405.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":64,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2025.1.spine241372","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}