{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:07:06Z","timestamp":1772827626576,"version":"3.50.1"},"reference-count":72,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,28]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Older patients are increasingly undergoing anterior cervical discectomy and fusion (ACDF). Although studies have examined complication rates in older patients, the correlation between age and achieving specific patient-reported outcomes (PROs) is lacking. The authors sought to determine whether older patients undergoing ACDF are independently associated with lower odds of achieving minimal clinically important difference (MCID) for pain and physical function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors queried the Michigan Spine Surgery Improvement Collaborative (MSSIC) registry for patients who underwent 1- to 4-level ACDF (March 2014 to July 2019) for degenerative conditions. PROs were measured at baseline, 90 days, 1 year, and 2 years using the neck and arm numerical rating scale (NRS), Patient-Reported Outcomes Measurement Information System\u2013Physical Function (PROMIS-PF), EQ-5D, and North American Spine Society (NASS) satisfaction index. Patients were divided into older (\u2265 70 years old) versus younger (&lt; 70 years) groups. The authors used univariate analysis to compare demographic characteristics, operative characteristics, and proportions that achieved MCID between the age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>This study included 7732 patients (6887 [89.1%] &lt; 70 years old and 845 [10.9%] \u2265 70 years old). Unadjusted results demonstrated that older patients had a significantly higher rate of any complication within 90 days (26% vs 19%, p &lt; 0.001), longer length of stay (2.6 days vs 1.7 days, p &lt; 0.001), higher rates of MCID in neck NRS score at any time (76.9% vs 70.3%, p = 0.02) and at 90 days (71.3% vs 60.6%, p = 0.002), and lower rates of MCID in PROMIS-PF score at 1 year (52.7% vs 59.6%, p = 0.044) and 2 years (45.9% vs 57.7%, p = 0.002). Age was not independently associated with any PRO. Independent preoperative ambulation (OR 1.80, p &lt; 0.001) and ambulation at postoperative day 0 (OR 1.25, p &lt; 0.001) were independently associated with significantly increased odds of achieving MCID in PROMIS-PF score. Minor complications within 90 days (OR 0.67, p &lt; 0.001) and lower baseline PROMIS-PF score (OR 0.89, p &lt; 0.001) were independently associated with significantly decreased odds of achieving PROMIS-PF score. For the older subgroup, independent preoperative ambulation (OR 2.11, 95% CI 1.44\u20133.09, p &lt; 0.001) had significantly increased odds of achieving MCID in PROMIS-PF score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Unadjusted results demonstrated that older patients had significantly longer length of stay and complication rates within 90 days. Adjusted analyses demonstrated that advanced age was not independently associated with PROs in patients undergoing ACDF. However, independent early postoperative and preoperative ambulation were associated with significantly increased odds of improved PROs following ACDF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.7.spine2585","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T17:40:56Z","timestamp":1765215656000},"page":"226-234","source":"Crossref","is-referenced-by-count":0,"title":["Age as a predictor of patient-reported outcomes in anterior cervical discectomy and fusion: analysis of the Michigan Spine Surgery Improvement Collaborative"],"prefix":"10.3171","volume":"44","author":[{"given":"Roxana N.","family":"Beladi","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Henry Ford Providence Hospital, Michigan State University, College of Human Medicine, Southfield;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael H.","family":"Lawless","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Henry Ford Providence Hospital, Michigan State University, College of Human Medicine, Southfield;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Henry Ford Hospital, Detroit;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenxi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Michigan State University, East Lansing;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chad F.","family":"Claus","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Henry Ford Providence Hospital, Michigan State University, College of Human Medicine, Southfield;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A.","family":"Carr","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Henry Ford Providence Hospital, Michigan State University, College of Human Medicine, Southfield;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifford M.","family":"Houseman","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Henry Ford Providence Hospital, Michigan State University, College of Human Medicine, Southfield;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashant S.","family":"Kelkar","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Henry Ford Providence Hospital, Michigan State University, College of Human Medicine, Southfield;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boyd","family":"Richards","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Henry Ford Providence Hospital, Michigan State University, College of Human Medicine, Southfield;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muwaffak M.","family":"Abdulhak","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Henry Ford Hospital, Detroit;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilyas S.","family":"Aleem","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Michigan, Ann Arbor;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jad G.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Beaumont University Hospital, Royal Oak;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguelangelo Jorge","family":"Perez-Cruet","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Royal Oak;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Easton","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Beaumont Troy Hospital, Troy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Nerenz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Henry Ford Hospital, Detroit;"},{"name":"Center for Health Policy & Health Services Research, Henry Ford Health, Detroit;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noojan J.","family":"Kazemi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Taliaferro","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhui","family":"Hu","sequence":"additional","affiliation":[{"name":"Center for Health Policy & Health Services Research, Henry Ford Health, Detroit;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Henry Ford Hospital, Detroit;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teck M.","family":"Soo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Henry Ford Providence Hospital, Michigan State University, College of Human Medicine, Southfield;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Neurosurgery","first-page":"753","article-title":"National trends in surgical procedures for degenerative cervical spine disease: 1990-2000","volume":"57","author":"Patil PG","year":"2005","unstructured":"Patil PG, Turner DA, Pietrobon R. National trends in surgical procedures for degenerative cervical spine disease: 1990-2000. Neurosurgery. 2005;57(4):753\u2013758."},{"issue":"1","key":"b2","series-title":"Neurosurgery","first-page":"15","article-title":"The utilization of spinal fusion in the United States","volume":"59","author":"Cowan JA","year":"2006","unstructured":"Cowan JA, Dimick JB, Wainess R, Upchurch GR, Chandler WF, La Marca F. The utilization of spinal fusion in the United States. Neurosurgery. 2006;59(1):15\u201320."},{"issue":"15","key":"b3","series-title":"Spine (Phila Pa 1976)","first-page":"1454","article-title":"National trends in anterior cervical fusion procedures","volume":"35","author":"Marawar S","year":"2010","unstructured":"Marawar S, Girardi FP, Sama AA,  National trends in anterior cervical fusion procedures. Spine (Phila Pa 1976). 2010;35(15):1454\u20131459."},{"issue":"14","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1226","article-title":"Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009","volume":"38","author":"Oglesby M","year":"2013","unstructured":"Oglesby M, Fineberg SJ, Patel AA, Pelton MA, Singh K. Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009. Spine (Phila Pa 1976). 2013;38(14):1226\u20131232."},{"issue":"1","key":"b5","series-title":"Spine J","first-page":"31","article-title":"Impact of surgical approach on complications and resource utilization of cervical spine fusion: a nationwide perspective to the surgical treatment of diffuse cervical spondylosis","volume":"9","author":"Shamji MF","year":"2009","unstructured":"Shamji MF, Cook C, Pietrobon R, Tackett S, Brown C, Isaacs RE. Impact of surgical approach on complications and resource utilization of cervical spine fusion: a nationwide perspective to the surgical treatment of diffuse cervical spondylosis. Spine J. 2009;9(1):31\u201338."},{"issue":"6","key":"b6","series-title":"J Neurosurg Spine","first-page":"835","article-title":"Predictors of patient satisfaction following 1- or 2-level anterior cervical discectomy and fusion: insights from the Quality Outcomes Database","volume":"31","author":"Asher AL","year":"2019","unstructured":"Asher AL, Devin CJ, Kerezoudis P,  Predictors of patient satisfaction following 1- or 2-level anterior cervical discectomy and fusion: insights from the Quality Outcomes Database. J Neurosurg Spine. 2019;31(6):835\u2013843."},{"issue":"6","key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"356","article-title":"Age as a predictor for complications and patient-reported outcomes in multilevel transforaminal lumbar interbody fusions: analyses from the Michigan Spine Surgery Improvement Collaborative (MSSIC)","volume":"46","author":"Claus CF","year":"2021","unstructured":"Claus CF, Tong D, Lytle E,  Age as a predictor for complications and patient-reported outcomes in multilevel transforaminal lumbar interbody fusions: analyses from the Michigan Spine Surgery Improvement Collaborative (MSSIC). Spine (Phila Pa 1976). 2021;46(6):356\u2013365."},{"issue":"11","key":"b8","series-title":"Spine (Phila Pa 1976)","first-page":"735","article-title":"Elderly as a predictor for perioperative complications in patients undergoing multilevel minimally invasive transforaminal lumbar interbody fusion: a regression modeling study","volume":"45","author":"Claus CF","year":"2020","unstructured":"Claus CF, Lytle E, Tong D,  Elderly as a predictor for perioperative complications in patients undergoing multilevel minimally invasive transforaminal lumbar interbody fusion: a regression modeling study. Spine (Phila Pa 1976). 2020;45(11):735\u2013740."},{"issue":"6","key":"b9","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Surgical outcomes of elderly patients with cervical spondylotic myelopathy: a meta-analysis of studies reporting on 2868 patients","volume":"40","author":"Madhavan K","year":"2016","unstructured":"Madhavan K, Chieng LO, Foong H, Wang MY. Surgical outcomes of elderly patients with cervical spondylotic myelopathy: a meta-analysis of studies reporting on 2868 patients. Neurosurg Focus. 2016;40(6):E13."},{"issue":"5","key":"b10","series-title":"Global Spine J","first-page":"425","article-title":"Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion","volume":"7","author":"Di Capua J","year":"2017","unstructured":"Di Capua J, Somani S, Kim JS,  Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion. Global Spine J. 2017;7(5):425\u2013431."},{"issue":"1","key":"b11","series-title":"Sci Rep","first-page":"4495","article-title":"The surgical outcome of multilevel anterior cervical discectomy and fusion in myelopathic elderly and younger patients","volume":"12","author":"Luo CA","year":"2022","unstructured":"Luo CA, Lim AS, Lu ML, Chiu PY, Lai PL, Niu CC. The surgical outcome of multilevel anterior cervical discectomy and fusion in myelopathic elderly and younger patients. Sci Rep. 2022;12(1):4495."},{"issue":"2","key":"b12","series-title":"Global Spine J","first-page":"615","article-title":"An 11-year-long analysis of the risks associated with age in patients undergoing anterior cervical discectomy and fusion in a large, urban academic hospital","volume":"15","author":"Tang J","year":"2025","unstructured":"Tang J, Gal JS, Geng E,  An 11-year-long analysis of the risks associated with age in patients undergoing anterior cervical discectomy and fusion in a large, urban academic hospital. Global Spine J. 2025;15(2):615\u2013620."},{"issue":"1","key":"b13","series-title":"Neurospine","first-page":"156","article-title":"Radiological and clinical outcomes of anterior cervical discectomy and fusion in older patients: a comparative analysis of young-old patients (ages 65\u201374 years) and middle-old patients (over 75 years)","volume":"17","author":"Lee CH","year":"2020","unstructured":"Lee CH, Son DW, Lee SH,  Radiological and clinical outcomes of anterior cervical discectomy and fusion in older patients: a comparative analysis of young-old patients (ages 65\u201374 years) and middle-old patients (over 75 years). Neurospine. 2020;17(1):156\u2013163."},{"key":"b14","series-title":"Issue Brief: Is 65 the Best Cutoff for Defining \"Older Americans?\"","author":"Moon M","year":"2015","unstructured":"Moon M, Guo J, McSorley E. Issue Brief: Is 65 the Best Cutoff for Defining \"Older Americans?\". American Institutes for Research; 2015.Accessed August 15, 2025.https:\/\/www.air.org\/sites\/default\/files\/downloads\/report\/Center-on-Aging-Is-65-the-Best-Cutoff-for-Defining-Older-Americans-Jan2015.pdf"},{"issue":"10","key":"b15","series-title":"J Clin Med","first-page":"1708","article-title":"The impact of older age on functional recovery and quality of life outcomes after surgical decompression for degenerative cervical myelopathy: results from an ambispective, propensity-matched analysis from the CSM-NA and CSM-I international, multi-center studies","volume":"8","author":"Wilson JRF","year":"2019","unstructured":"Wilson JRF, Badhiwala JH, Jiang F,  The impact of older age on functional recovery and quality of life outcomes after surgical decompression for degenerative cervical myelopathy: results from an ambispective, propensity-matched analysis from the CSM-NA and CSM-I international, multi-center studies. J Clin Med. 2019;8(10):1708."},{"issue":"4","key":"b16","series-title":"Spine (Phila Pa 1976)","first-page":"343","article-title":"Age as a risk factor for complications following anterior cervical discectomy and fusion: analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC)","volume":"47","author":"Lawless MH","year":"2022","unstructured":"Lawless MH, Tong D, Claus CF,  Age as a risk factor for complications following anterior cervical discectomy and fusion: analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC). Spine (Phila Pa 1976). 2022;47(4):343\u2013351."},{"issue":"9","key":"b17","series-title":"Acta Neurochir (Wien)","first-page":"2317","article-title":"Surgery for degenerative cervical myelopathy in the elderly: a nationwide registry-based observational study with patient-reported outcomes","volume":"164","author":"Johansen TO","year":"2022","unstructured":"Johansen TO, Vangen-L\u00f8nne V, Holmberg ST,  Surgery for degenerative cervical myelopathy in the elderly: a nationwide registry-based observational study with patient-reported outcomes. Acta Neurochir (Wien). 2022;164(9):2317\u20132326."},{"issue":"10","key":"b18","series-title":"PLoS Med","first-page":"e1001885","article-title":"The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement","volume":"12","author":"Benchimol EI","year":"2015","unstructured":"Benchimol EI, Smeeth L, Guttmann A,  The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. PLoS Med. 2015;12(10):e1001885."},{"issue":"6","key":"b19","series-title":"Neurosurg Focus","first-page":"E7","article-title":"The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative","volume":"39","author":"Chang V","year":"2015","unstructured":"Chang V, Schwalb JM, Nerenz DR,  The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative. Neurosurg Focus. 2015;39(6):E7."},{"issue":"3","key":"b20","series-title":"J Neurosurg Spine","first-page":"268","article-title":"Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery","volume":"28","author":"Boody BS","year":"2018","unstructured":"Boody BS, Bhatt S, Mazmudar AS, Hsu WK, Rothrock NE, Patel AA. Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery. J Neurosurg Spine. 2018;28(3):268\u2013279."},{"key":"b21","series-title":"Scand J Pain","first-page":"67","article-title":"How to analyze the visual analogue scale: myths, truths and clinical relevance","volume":"13","author":"Heller GZ","year":"2016","unstructured":"Heller GZ, Manuguerra M, Chow R. How to analyze the visual analogue scale: myths, truths and clinical relevance. Scand J Pain. 2016;13:67\u201375."},{"issue":"5","key":"b22","series-title":"Ann Med","first-page":"337","article-title":"EQ-5D: a measure of health status from the EuroQol Group","volume":"33","author":"Rabin R","year":"2001","unstructured":"Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337\u2013343."},{"key":"b23","series-title":"World Neurosurg","first-page":"e724\u20139","article-title":"Correlation between the Oswestry Disability Index and the North American Spine Surgery Patient Satisfaction Index","volume":"139","author":"Yee TJ","year":"2020","unstructured":"Yee TJ, Fearer KJ, Oppenlander ME,  Correlation between the Oswestry Disability Index and the North American Spine Surgery Patient Satisfaction Index. World Neurosurg. 2020;139:e724\u20139\u2013e729."},{"issue":"26","key":"b24","series-title":"Spine (Phila Pa 1976)","first-page":"3047","article-title":"Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain","volume":"32","author":"Pool JJM","year":"2007","unstructured":"Pool JJM, Ostelo RWJG, Hoving JL, Bouter LM, de Vet HCW. Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain. Spine (Phila Pa 1976). 2007;32(26):3047\u20133051."},{"issue":"6","key":"b25","series-title":"Spine J","first-page":"469","article-title":"Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10(6):469\u2013474."},{"issue":"12","key":"b26","series-title":"Spine J","first-page":"1122","article-title":"Determination of minimum clinically important difference (MCID) in pain, disability, and quality of life after revision fusion for symptomatic pseudoarthrosis","volume":"12","author":"Parker SL","year":"2012","unstructured":"Parker SL, Adogwa O, Mendenhall SK,  Determination of minimum clinically important difference (MCID) in pain, disability, and quality of life after revision fusion for symptomatic pseudoarthrosis. Spine J. 2012;12(12):1122\u20131128."},{"issue":"4","key":"b27","series-title":"Spine J","first-page":"600","article-title":"Adding 3-month patient data improves prognostic models of 12-month disability, pain, and satisfaction after specific lumbar spine surgical procedures: development and validation of a prediction model","volume":"20","author":"Rundell SD","year":"2020","unstructured":"Rundell SD, Pennings JS, Nian H,  Adding 3-month patient data improves prognostic models of 12-month disability, pain, and satisfaction after specific lumbar spine surgical procedures: development and validation of a prediction model. Spine J. 2020;20(4):600\u2013613."},{"key":"b28","series-title":"Sample Size Determination and Power","author":"Ryan TP","year":"2013","unstructured":"Ryan TP. Sample Size Determination and Power. John Wiley & Sons;2013."},{"issue":"12","key":"b29","series-title":"Clin Orthop Relat Res","first-page":"2893","article-title":"Results of database studies in spine surgery can be influenced by missing data","volume":"475","author":"Basques BA","year":"2017","unstructured":"Basques BA, McLynn RP, Fice MP,  Results of database studies in spine surgery can be influenced by missing data. Clin Orthop Relat Res. 2017;475(12):2893\u20132904."},{"issue":"3","key":"b30","series-title":"BMJ Evid Based Med","first-page":"103","article-title":"Big data registries in spine surgery research: the lurking dangers","volume":"26","author":"Claus CF","year":"2021","unstructured":"Claus CF, Lytle E, Carr DA, Tong D. Big data registries in spine surgery research: the lurking dangers. BMJ Evid Based Med. 2021;26(3):103\u2013105."},{"issue":"3","key":"b31","series-title":"Paediatr Respir Rev","first-page":"141","article-title":"Opportunities and pitfalls of registry data for clinical research","volume":"14","author":"Psoter KJ","year":"2013","unstructured":"Psoter KJ, Rosenfeld M. Opportunities and pitfalls of registry data for clinical research. Paediatr Respir Rev. 2013;14(3):141\u2013145."},{"issue":"7","key":"b32","series-title":"Acad Emerg Med","first-page":"662","article-title":"Advanced statistics: missing data in clinical research\u2013part 1: an introduction and conceptual framework","volume":"14","author":"Haukoos JS","year":"2007","unstructured":"Haukoos JS, Newgard CD. Advanced statistics: missing data in clinical research\u2013part 1: an introduction and conceptual framework. Acad Emerg Med. 2007;14(7):662\u2013668."},{"issue":"9","key":"b33","series-title":"JAMA","first-page":"940","article-title":"Missing data: how to best account for what is not known","volume":"314","author":"Newgard CD","year":"2015","unstructured":"Newgard CD, Lewis RJ. Missing data: how to best account for what is not known. JAMA. 2015;314(9):940\u2013941."},{"key":"b34","series-title":"J Clin Epidemiol","first-page":"185","article-title":"Handling missing data in clinical research","volume":"151","author":"Heymans MW","year":"2022","unstructured":"Heymans MW, Twisk JWR. Handling missing data in clinical research. J Clin Epidemiol. 2022;151:185\u2013188."},{"issue":"4","key":"b35","series-title":"Eur Spine J","first-page":"1236","article-title":"Impact of old age on patient-report outcomes and cost utility for anterior cervical discectomy and fusion surgery for degenerative spine disease","volume":"26","author":"Chotai S","year":"2017","unstructured":"Chotai S, Parker SL, Sielatycki JA,  Impact of old age on patient-report outcomes and cost utility for anterior cervical discectomy and fusion surgery for degenerative spine disease. Eur Spine J. 2017;26(4):1236\u20131245."},{"issue":"4","key":"b36","series-title":"J Neurosurg Spine","first-page":"403","article-title":"Positive predictive factors and subgroup analysis of clinically relevant improvement after anterior cervical decompression and fusion for cervical disc disease: a 10- to 13-year follow-up of a prospective randomized study: clinical article","volume":"19","author":"Hermansen A","year":"2013","unstructured":"Hermansen A, Hedlund R, Vavruch L, Peolsson A. Positive predictive factors and subgroup analysis of clinically relevant improvement after anterior cervical decompression and fusion for cervical disc disease: a 10- to 13-year follow-up of a prospective randomized study: clinical article. J Neurosurg Spine. 2013;19(4):403\u2013411."},{"issue":"4","key":"b1","series-title":"Neurosurgery","first-page":"753","article-title":"National trends in surgical procedures for degenerative cervical spine disease: 1990-2000","volume":"57","author":"Patil PG","year":"2005","unstructured":"Patil PG, Turner DA, Pietrobon R. National trends in surgical procedures for degenerative cervical spine disease: 1990-2000. Neurosurgery. 2005;57(4):753\u2013758."},{"issue":"1","key":"b2","series-title":"Neurosurgery","first-page":"15","article-title":"The utilization of spinal fusion in the United States","volume":"59","author":"Cowan JA","year":"2006","unstructured":"Cowan JA, Dimick JB, Wainess R, Upchurch GR, Chandler WF, La Marca F. The utilization of spinal fusion in the United States. Neurosurgery. 2006;59(1):15\u201320."},{"issue":"15","key":"b3","series-title":"Spine (Phila Pa 1976)","first-page":"1454","article-title":"National trends in anterior cervical fusion procedures","volume":"35","author":"Marawar S","year":"2010","unstructured":"Marawar S, Girardi FP, Sama AA,  National trends in anterior cervical fusion procedures. Spine (Phila Pa 1976). 2010;35(15):1454\u20131459."},{"issue":"14","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1226","article-title":"Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009","volume":"38","author":"Oglesby M","year":"2013","unstructured":"Oglesby M, Fineberg SJ, Patel AA, Pelton MA, Singh K. Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009. Spine (Phila Pa 1976). 2013;38(14):1226\u20131232."},{"issue":"1","key":"b5","series-title":"Spine J","first-page":"31","article-title":"Impact of surgical approach on complications and resource utilization of cervical spine fusion: a nationwide perspective to the surgical treatment of diffuse cervical spondylosis","volume":"9","author":"Shamji MF","year":"2009","unstructured":"Shamji MF, Cook C, Pietrobon R, Tackett S, Brown C, Isaacs RE. Impact of surgical approach on complications and resource utilization of cervical spine fusion: a nationwide perspective to the surgical treatment of diffuse cervical spondylosis. Spine J. 2009;9(1):31\u201338."},{"issue":"6","key":"b6","series-title":"J Neurosurg Spine","first-page":"835","article-title":"Predictors of patient satisfaction following 1- or 2-level anterior cervical discectomy and fusion: insights from the Quality Outcomes Database","volume":"31","author":"Asher AL","year":"2019","unstructured":"Asher AL, Devin CJ, Kerezoudis P,  Predictors of patient satisfaction following 1- or 2-level anterior cervical discectomy and fusion: insights from the Quality Outcomes Database. J Neurosurg Spine. 2019;31(6):835\u2013843."},{"issue":"6","key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"356","article-title":"Age as a predictor for complications and patient-reported outcomes in multilevel transforaminal lumbar interbody fusions: analyses from the Michigan Spine Surgery Improvement Collaborative (MSSIC)","volume":"46","author":"Claus CF","year":"2021","unstructured":"Claus CF, Tong D, Lytle E,  Age as a predictor for complications and patient-reported outcomes in multilevel transforaminal lumbar interbody fusions: analyses from the Michigan Spine Surgery Improvement Collaborative (MSSIC). Spine (Phila Pa 1976). 2021;46(6):356\u2013365."},{"issue":"11","key":"b8","series-title":"Spine (Phila Pa 1976)","first-page":"735","article-title":"Elderly as a predictor for perioperative complications in patients undergoing multilevel minimally invasive transforaminal lumbar interbody fusion: a regression modeling study","volume":"45","author":"Claus CF","year":"2020","unstructured":"Claus CF, Lytle E, Tong D,  Elderly as a predictor for perioperative complications in patients undergoing multilevel minimally invasive transforaminal lumbar interbody fusion: a regression modeling study. Spine (Phila Pa 1976). 2020;45(11):735\u2013740."},{"issue":"6","key":"b9","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Surgical outcomes of elderly patients with cervical spondylotic myelopathy: a meta-analysis of studies reporting on 2868 patients","volume":"40","author":"Madhavan K","year":"2016","unstructured":"Madhavan K, Chieng LO, Foong H, Wang MY. Surgical outcomes of elderly patients with cervical spondylotic myelopathy: a meta-analysis of studies reporting on 2868 patients. Neurosurg Focus. 2016;40(6):E13."},{"issue":"5","key":"b10","series-title":"Global Spine J","first-page":"425","article-title":"Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion","volume":"7","author":"Di Capua J","year":"2017","unstructured":"Di Capua J, Somani S, Kim JS,  Elderly age as a risk factor for 30-day postoperative outcomes following elective anterior cervical discectomy and fusion. Global Spine J. 2017;7(5):425\u2013431."},{"issue":"1","key":"b11","series-title":"Sci Rep","first-page":"4495","article-title":"The surgical outcome of multilevel anterior cervical discectomy and fusion in myelopathic elderly and younger patients","volume":"12","author":"Luo CA","year":"2022","unstructured":"Luo CA, Lim AS, Lu ML, Chiu PY, Lai PL, Niu CC. The surgical outcome of multilevel anterior cervical discectomy and fusion in myelopathic elderly and younger patients. Sci Rep. 2022;12(1):4495."},{"issue":"2","key":"b12","series-title":"Global Spine J","first-page":"615","article-title":"An 11-year-long analysis of the risks associated with age in patients undergoing anterior cervical discectomy and fusion in a large, urban academic hospital","volume":"15","author":"Tang J","year":"2025","unstructured":"Tang J, Gal JS, Geng E,  An 11-year-long analysis of the risks associated with age in patients undergoing anterior cervical discectomy and fusion in a large, urban academic hospital. Global Spine J. 2025;15(2):615\u2013620."},{"issue":"1","key":"b13","series-title":"Neurospine","first-page":"156","article-title":"Radiological and clinical outcomes of anterior cervical discectomy and fusion in older patients: a comparative analysis of young-old patients (ages 65\u201374 years) and middle-old patients (over 75 years)","volume":"17","author":"Lee CH","year":"2020","unstructured":"Lee CH, Son DW, Lee SH,  Radiological and clinical outcomes of anterior cervical discectomy and fusion in older patients: a comparative analysis of young-old patients (ages 65\u201374 years) and middle-old patients (over 75 years). Neurospine. 2020;17(1):156\u2013163."},{"key":"b14","series-title":"Issue Brief: Is 65 the Best Cutoff for Defining \"Older Americans?\"","author":"Moon M","year":"2015","unstructured":"Moon M, Guo J, McSorley E. Issue Brief: Is 65 the Best Cutoff for Defining \"Older Americans?\". American Institutes for Research; 2015.Accessed August 15, 2025.https:\/\/www.air.org\/sites\/default\/files\/downloads\/report\/Center-on-Aging-Is-65-the-Best-Cutoff-for-Defining-Older-Americans-Jan2015.pdf"},{"issue":"10","key":"b15","series-title":"J Clin Med","first-page":"1708","article-title":"The impact of older age on functional recovery and quality of life outcomes after surgical decompression for degenerative cervical myelopathy: results from an ambispective, propensity-matched analysis from the CSM-NA and CSM-I international, multi-center studies","volume":"8","author":"Wilson JRF","year":"2019","unstructured":"Wilson JRF, Badhiwala JH, Jiang F,  The impact of older age on functional recovery and quality of life outcomes after surgical decompression for degenerative cervical myelopathy: results from an ambispective, propensity-matched analysis from the CSM-NA and CSM-I international, multi-center studies. J Clin Med. 2019;8(10):1708."},{"issue":"4","key":"b16","series-title":"Spine (Phila Pa 1976)","first-page":"343","article-title":"Age as a risk factor for complications following anterior cervical discectomy and fusion: analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC)","volume":"47","author":"Lawless MH","year":"2022","unstructured":"Lawless MH, Tong D, Claus CF,  Age as a risk factor for complications following anterior cervical discectomy and fusion: analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC). Spine (Phila Pa 1976). 2022;47(4):343\u2013351."},{"issue":"9","key":"b17","series-title":"Acta Neurochir (Wien)","first-page":"2317","article-title":"Surgery for degenerative cervical myelopathy in the elderly: a nationwide registry-based observational study with patient-reported outcomes","volume":"164","author":"Johansen TO","year":"2022","unstructured":"Johansen TO, Vangen-L\u00f8nne V, Holmberg ST,  Surgery for degenerative cervical myelopathy in the elderly: a nationwide registry-based observational study with patient-reported outcomes. Acta Neurochir (Wien). 2022;164(9):2317\u20132326."},{"issue":"10","key":"b18","series-title":"PLoS Med","first-page":"e1001885","article-title":"The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement","volume":"12","author":"Benchimol EI","year":"2015","unstructured":"Benchimol EI, Smeeth L, Guttmann A,  The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. PLoS Med. 2015;12(10):e1001885."},{"issue":"6","key":"b19","series-title":"Neurosurg Focus","first-page":"E7","article-title":"The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative","volume":"39","author":"Chang V","year":"2015","unstructured":"Chang V, Schwalb JM, Nerenz DR,  The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative. Neurosurg Focus. 2015;39(6):E7."},{"issue":"3","key":"b20","series-title":"J Neurosurg Spine","first-page":"268","article-title":"Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery","volume":"28","author":"Boody BS","year":"2018","unstructured":"Boody BS, Bhatt S, Mazmudar AS, Hsu WK, Rothrock NE, Patel AA. Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery. J Neurosurg Spine. 2018;28(3):268\u2013279."},{"key":"b21","series-title":"Scand J Pain","first-page":"67","article-title":"How to analyze the visual analogue scale: myths, truths and clinical relevance","volume":"13","author":"Heller GZ","year":"2016","unstructured":"Heller GZ, Manuguerra M, Chow R. How to analyze the visual analogue scale: myths, truths and clinical relevance. Scand J Pain. 2016;13:67\u201375."},{"issue":"5","key":"b22","series-title":"Ann Med","first-page":"337","article-title":"EQ-5D: a measure of health status from the EuroQol Group","volume":"33","author":"Rabin R","year":"2001","unstructured":"Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337\u2013343."},{"key":"b23","series-title":"World Neurosurg","first-page":"e724\u20139","article-title":"Correlation between the Oswestry Disability Index and the North American Spine Surgery Patient Satisfaction Index","volume":"139","author":"Yee TJ","year":"2020","unstructured":"Yee TJ, Fearer KJ, Oppenlander ME,  Correlation between the Oswestry Disability Index and the North American Spine Surgery Patient Satisfaction Index. World Neurosurg. 2020;139:e724\u20139\u2013e729."},{"issue":"26","key":"b24","series-title":"Spine (Phila Pa 1976)","first-page":"3047","article-title":"Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain","volume":"32","author":"Pool JJM","year":"2007","unstructured":"Pool JJM, Ostelo RWJG, Hoving JL, Bouter LM, de Vet HCW. Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain. Spine (Phila Pa 1976). 2007;32(26):3047\u20133051."},{"issue":"6","key":"b25","series-title":"Spine J","first-page":"469","article-title":"Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10(6):469\u2013474."},{"issue":"12","key":"b26","series-title":"Spine J","first-page":"1122","article-title":"Determination of minimum clinically important difference (MCID) in pain, disability, and quality of life after revision fusion for symptomatic pseudoarthrosis","volume":"12","author":"Parker SL","year":"2012","unstructured":"Parker SL, Adogwa O, Mendenhall SK,  Determination of minimum clinically important difference (MCID) in pain, disability, and quality of life after revision fusion for symptomatic pseudoarthrosis. Spine J. 2012;12(12):1122\u20131128."},{"issue":"4","key":"b27","series-title":"Spine J","first-page":"600","article-title":"Adding 3-month patient data improves prognostic models of 12-month disability, pain, and satisfaction after specific lumbar spine surgical procedures: development and validation of a prediction model","volume":"20","author":"Rundell SD","year":"2020","unstructured":"Rundell SD, Pennings JS, Nian H,  Adding 3-month patient data improves prognostic models of 12-month disability, pain, and satisfaction after specific lumbar spine surgical procedures: development and validation of a prediction model. Spine J. 2020;20(4):600\u2013613."},{"key":"b28","series-title":"Sample Size Determination and Power","author":"Ryan TP","year":"2013","unstructured":"Ryan TP. Sample Size Determination and Power. John Wiley & Sons;2013."},{"issue":"12","key":"b29","series-title":"Clin Orthop Relat Res","first-page":"2893","article-title":"Results of database studies in spine surgery can be influenced by missing data","volume":"475","author":"Basques BA","year":"2017","unstructured":"Basques BA, McLynn RP, Fice MP,  Results of database studies in spine surgery can be influenced by missing data. Clin Orthop Relat Res. 2017;475(12):2893\u20132904."},{"issue":"3","key":"b30","series-title":"BMJ Evid Based Med","first-page":"103","article-title":"Big data registries in spine surgery research: the lurking dangers","volume":"26","author":"Claus CF","year":"2021","unstructured":"Claus CF, Lytle E, Carr DA, Tong D. Big data registries in spine surgery research: the lurking dangers. BMJ Evid Based Med. 2021;26(3):103\u2013105."},{"issue":"3","key":"b31","series-title":"Paediatr Respir Rev","first-page":"141","article-title":"Opportunities and pitfalls of registry data for clinical research","volume":"14","author":"Psoter KJ","year":"2013","unstructured":"Psoter KJ, Rosenfeld M. Opportunities and pitfalls of registry data for clinical research. Paediatr Respir Rev. 2013;14(3):141\u2013145."},{"issue":"7","key":"b32","series-title":"Acad Emerg Med","first-page":"662","article-title":"Advanced statistics: missing data in clinical research\u2013part 1: an introduction and conceptual framework","volume":"14","author":"Haukoos JS","year":"2007","unstructured":"Haukoos JS, Newgard CD. Advanced statistics: missing data in clinical research\u2013part 1: an introduction and conceptual framework. Acad Emerg Med. 2007;14(7):662\u2013668."},{"issue":"9","key":"b33","series-title":"JAMA","first-page":"940","article-title":"Missing data: how to best account for what is not known","volume":"314","author":"Newgard CD","year":"2015","unstructured":"Newgard CD, Lewis RJ. Missing data: how to best account for what is not known. JAMA. 2015;314(9):940\u2013941."},{"key":"b34","series-title":"J Clin Epidemiol","first-page":"185","article-title":"Handling missing data in clinical research","volume":"151","author":"Heymans MW","year":"2022","unstructured":"Heymans MW, Twisk JWR. Handling missing data in clinical research. J Clin Epidemiol. 2022;151:185\u2013188."},{"issue":"4","key":"b35","series-title":"Eur Spine J","first-page":"1236","article-title":"Impact of old age on patient-report outcomes and cost utility for anterior cervical discectomy and fusion surgery for degenerative spine disease","volume":"26","author":"Chotai S","year":"2017","unstructured":"Chotai S, Parker SL, Sielatycki JA,  Impact of old age on patient-report outcomes and cost utility for anterior cervical discectomy and fusion surgery for degenerative spine disease. Eur Spine J. 2017;26(4):1236\u20131245."},{"issue":"4","key":"b36","series-title":"J Neurosurg Spine","first-page":"403","article-title":"Positive predictive factors and subgroup analysis of clinically relevant improvement after anterior cervical decompression and fusion for cervical disc disease: a 10- to 13-year follow-up of a prospective randomized study: clinical article","volume":"19","author":"Hermansen A","year":"2013","unstructured":"Hermansen A, Hedlund R, Vavruch L, Peolsson A. Positive predictive factors and subgroup analysis of clinically relevant improvement after anterior cervical decompression and fusion for cervical disc disease: a 10- to 13-year follow-up of a prospective randomized study: clinical article. J Neurosurg Spine. 2013;19(4):403\u2013411."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/2\/article-p226.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/2\/article-p226.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/2\/article-p226.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:45:30Z","timestamp":1772804730000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/2\/article-p226.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":72,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2025.7.spine2585","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,28]]}}}