{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:02Z","timestamp":1776096422683,"version":"3.50.1"},"reference-count":48,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,16]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to determine predictors of the minimum clinically important difference (MCID) in the Neck Disability Index (NDI) following cervical spinal deformity surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective review was performed of a prospective, multicenter adult cervical spinal deformity database. All patients had baseline and 1-year NDI scores. Patients met MCID with an improvement of NDI by 7 points between baseline and 1 year, as previously established. Baseline demographics, comorbidities, and both baseline and 1-year spinopelvic parameters were evaluated for statistical significance in a univariate logistic regression analysis. Significant variables, in addition to baseline NDI, were analyzed in a multivariable logistic regression model by backward selection with Akaike information criterion minimization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 122 patients were included with a median age of 62 (IQR 56, 69) years; 62% of patients were female. Of the 122 patients, 72 (59%) achieved NDI MCID at 1 year. Predictors of achieving MCID on univariate analysis included a lower Charlson Comorbidity Index (CCI) total score (OR 0.70, p = 0.03), depression as a comorbidity (OR 2.9, p = 0.02), lower C2 tilt at the 1-year follow-up (OR 0.92, p = 0.02), and a greater difference between 1-year postoperative C2\u20137 sagittal vertical axis (SVA) and preoperative C2\u20137 SVA (OR 0.98, p = 0.0495). On multivariable logistic regression analysis, predictors of achieving MCID included a lower CCI (OR 0.62, p = 0.03), depression as a comorbidity (OR 3.1, p = 0.059), a greater change in C2\u20137 SVA at the 1-year follow-up compared with baseline (OR 0.97, p = 0.055), and baseline NDI (OR 1.02, p = 0.24) with an area under the curve of 0.74.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The best-fit multivariable model included higher baseline NDI, a greater change in C2\u20137 SVA, patient-reported baseline depression, and lower CCI as important factors in predicting NDI MCID.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.9.spine25668","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:12Z","timestamp":1769083212000},"page":"581-588","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of achieving Neck Disability Index minimum clinically important difference following cervical deformity surgery"],"prefix":"10.3171","volume":"44","author":[{"given":"Anthony L.","family":"Mikula","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin K.","family":"Scheer","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Cedars Sinai Medical Center, Los Angeles, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay D.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey P.","family":"Mullin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Buffalo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York;"}],"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"}]},{"given":"Khaled M.","family":"Kebaish","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric O.","family":"Klineberg","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Texas Health Houston, Texas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory M.","family":"Mundis","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Scripps Institute, La Jolla, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan H.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Brown University, Providence, Rhode Island;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert K.","family":"Eastlack","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Scripps Institute, La Jolla, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Orthopedic Surgery, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Themistocles S.","family":"Protopsaltis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Soroceanu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Calgary, Alberta, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munish C.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Washington University, St. Louis, Missouri;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Rady Children\u2019s Hospital, San Diego, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[{"name":"Presbyterian St. Luke\u2019s Medical Center, Denver, Colorado; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Neurosurgery","first-page":"864","article-title":"Alignment, classification, clinical evaluation, and surgical treatment for adult cervical deformity: a complete guide","volume":"88","author":"Scheer JK","year":"2021","unstructured":"Scheer JK, Lau D, Smith JS,  Alignment, classification, clinical evaluation, and surgical treatment for adult cervical deformity: a complete guide. Neurosurgery. 2021;88(4):864\u2013883."},{"issue":"5","key":"b2","series-title":"Neurosurgery","first-page":"716","article-title":"The health impact of adult cervical deformity in patients presenting for surgical treatment: comparison to United States population norms and chronic disease states based on the EuroQuol-5 Dimensions Questionnaire","volume":"80","author":"Smith JS","year":"2017","unstructured":"Smith JS, Line B, Bess S,  The health impact of adult cervical deformity in patients presenting for surgical treatment: comparison to United States population norms and chronic disease states based on the EuroQuol-5 Dimensions Questionnaire. Neurosurgery. 2017;80(5):716\u2013725."},{"issue":"2","key":"b3","series-title":"Global Spine J","first-page":"846","article-title":"Adult cervical deformity patients have higher baseline frailty, disability, and comorbidities compared with complex adult thoracolumbar deformity patients: a comparative cohort study of 616 patients","volume":"15","author":"Smith JS","year":"2025","unstructured":"Smith JS, Kelly MP, Buell TJ,  Adult cervical deformity patients have higher baseline frailty, disability, and comorbidities compared with complex adult thoracolumbar deformity patients: a comparative cohort study of 616 patients. Global Spine J. 2025;15(2):846\u2013857."},{"issue":"2","key":"b4","series-title":"J Neurosurg Spine","first-page":"141","article-title":"Cervical spine alignment, sagittal deformity, and clinical implications: a review","volume":"19","author":"Scheer JK","year":"2013","unstructured":"Scheer JK, Tang JA, Smith JS,  Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine. 2013;19(2):141\u2013159."},{"issue":"3","key":"b5","series-title":"Neurospine","first-page":"506","article-title":"Prioritization of realignment associated with superior clinical outcomes for cervical deformity patients","volume":"18","author":"Pierce KE","year":"2021","unstructured":"Pierce KE, Passias PG, Brown AE,  Prioritization of realignment associated with superior clinical outcomes for cervical deformity patients. Neurospine. 2021;18(3):506\u2013514."},{"issue":"3","key":"b6","series-title":"J Neurosurg Spine","first-page":"309","article-title":"The gap between surgeon goal and achieved sagittal alignment in adult cervical spine deformity surgery","volume":"42","author":"Smith JS","year":"2025","unstructured":"Smith JS, Ben-Israel D, Kelly MP,  The gap between surgeon goal and achieved sagittal alignment in adult cervical spine deformity surgery. J Neurosurg Spine. 2025;42(3):309\u2013319."},{"issue":"4","key":"b7","series-title":"Neurosurgery","first-page":"559","article-title":"The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort","volume":"73","author":"Terran J","year":"2013","unstructured":"Terran J, Schwab F, Shaffrey CI,  The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort. Neurosurgery. 2013;73(4):559\u2013568."},{"issue":"23","key":"b8","series-title":"J Bone Joint Surg Am","first-page":"e48","article-title":"The T4-L1-hip axis: sagittal spinal realignment targets in long-construct adult spinal deformity surgery: early impact","volume":"106","author":"Hills J","year":"2024","unstructured":"Hills J, Mundis GM, Klineberg EO,  The T4-L1-hip axis: sagittal spinal realignment targets in long-construct adult spinal deformity surgery: early impact. J Bone Joint Surg Am. 2024;106(23):e48."},{"issue":"19","key":"b9","series-title":"Spine (Phila Pa 1976).","first-page":"1399","article-title":"The T4-L1-hip axis: defining a normal sagittal spinal alignment","volume":"47","author":"Hills J","year":"2022","unstructured":"Hills J, Lenke LG, Sardar ZM,  The T4-L1-hip axis: defining a normal sagittal spinal alignment. Spine (Phila Pa 1976).2022;47(19):1399\u20131406."},{"issue":"6","key":"b10","series-title":"J Neurosurg Spine","first-page":"673","article-title":"Reliability assessment of a novel cervical spine deformity classification system","volume":"23","author":"Ames CP","year":"2015","unstructured":"Ames CP, Smith JS, Eastlack R,  Reliability assessment of a novel cervical spine deformity classification system. J Neurosurg Spine. 2015;23(6):673\u2013683."},{"issue":"4","key":"b11","series-title":"J Neurosurg Spine","first-page":"441","article-title":"Establishing the minimum clinically important difference in Neck Disability Index and modified Japanese Orthopaedic Association scores for adult cervical deformity","volume":"33","author":"Soroceanu A","year":"2020","unstructured":"Soroceanu A, Smith JS, Lau D,  Establishing the minimum clinically important difference in Neck Disability Index and modified Japanese Orthopaedic Association scores for adult cervical deformity. J Neurosurg Spine. 2020;33(4):441\u2013445."},{"issue":"6","key":"b12","series-title":"Spine J","first-page":"968","article-title":"Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales","volume":"8","author":"Copay AG","year":"2008","unstructured":"Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. 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Neurosurgery. 2015;76Suppl 1:S14-21."},{"issue":"5","key":"b16","series-title":"J Neurosurg Spine","first-page":"849","article-title":"Comparison of frailty metrics and the Charlson Comorbidity Index for predicting adverse outcomes in patients undergoing surgery for spine metastases","volume":"36","author":"Hersh AM","year":"2022","unstructured":"Hersh AM, Pennington Z, Hung B,  Comparison of frailty metrics and the Charlson Comorbidity Index for predicting adverse outcomes in patients undergoing surgery for spine metastases. J Neurosurg Spine. 2022;36(5):849\u2013857."},{"key":"b17","series-title":"J Clin Neurosci","first-page":"23","article-title":"Utility of preoperative comorbidity burden on PROMIS outcomes after lumbar decompression: cohort matched analysis","volume":"121","author":"Roca AM","year":"2024","unstructured":"Roca AM, Anwar FN, Khosla I,  Utility of preoperative comorbidity burden on PROMIS outcomes after lumbar decompression: cohort matched analysis. J Clin Neurosci. 2024;121:23\u201327."},{"issue":"6","key":"b18","series-title":"Clin Spine Surg","first-page":"E294","article-title":"The impact of comorbidity burden on postoperative PROMIS physical function following minimally invasive transforaminal lumbar interbody fusion","volume":"33","author":"Parrish JM","year":"2020","unstructured":"Parrish JM, Jenkins NW, Hrynewycz NM, Brundage TS, Yoo JS, Singh K. The impact of comorbidity burden on postoperative PROMIS physical function following minimally invasive transforaminal lumbar interbody fusion. Clin Spine Surg. 2020;33(6):E294\u2013E298."},{"key":"b19","series-title":"World Neurosurg","first-page":"e157","article-title":"Severe comorbidity burden does not influence postoperative clinical outcomes and trajectory for back pain, leg pain, physical function, or disability in patients undergoing minimally invasive transforaminal lumbar interbody fusion: cohort-matched analysis","volume":"164","author":"Jacob KC","year":"2022","unstructured":"Jacob KC, Patel MR, Vanjani NN,  Severe comorbidity burden does not influence postoperative clinical outcomes and trajectory for back pain, leg pain, physical function, or disability in patients undergoing minimally invasive transforaminal lumbar interbody fusion: cohort-matched analysis. World Neurosurg. 2022;164:e157\u2013e168."},{"issue":"6","key":"b20","series-title":"Spine (Phila Pa 1976).","first-page":"383","article-title":"How do functional comorbidities affect PROMIS-PF scores following lumbar fusion surgery?","volume":"50","author":"Mizels J","year":"2025","unstructured":"Mizels J, Connelly J, Martin B,  How do functional comorbidities affect PROMIS-PF scores following lumbar fusion surgery? Spine (Phila Pa 1976).2025;50(6):383\u2013388."},{"key":"b21","series-title":"Front Surg","first-page":"991271","article-title":"The Charlson Comorbidity Index and depression are associated with satisfaction after short-segment lumbar fusion in patients 75 years and older","volume":"9","author":"Wang SK","year":"2022","unstructured":"Wang SK, Mu H, Wang P,  The Charlson Comorbidity Index and depression are associated with satisfaction after short-segment lumbar fusion in patients 75 years and older. Front Surg. 2022;9:991271."},{"issue":"4","key":"b22","series-title":"J Neurosurg Spine","first-page":"477","article-title":"Impact of preoperative depression on 2-year clinical outcomes following adult spinal deformity surgery: the importance of risk stratification based on type of psychological distress","volume":"25","author":"Theologis AA","year":"2016","unstructured":"Theologis AA, Ailon T, Scheer JK,  Impact of preoperative depression on 2-year clinical outcomes following adult spinal deformity surgery: the importance of risk stratification based on type of psychological distress. J Neurosurg Spine. 2016;25(4):477\u2013485."},{"issue":"Suppl 1","key":"b23","series-title":"Eur J Orthop Surg Traumatol","first-page":"S25","article-title":"Evaluation of psychosomatic distress and its influence in the outcomes of lumbar fusion procedures for degenerative disorders of the spine","volume":"25","author":"Vialle E","year":"2015","unstructured":"Vialle E, de Oliveira Pinto BM, Vialle LR, Gomez JDC. Evaluation of psychosomatic distress and its influence in the outcomes of lumbar fusion procedures for degenerative disorders of the spine. 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Neurosurgery. 2021;88(4):864\u2013883."},{"issue":"5","key":"b2","series-title":"Neurosurgery","first-page":"716","article-title":"The health impact of adult cervical deformity in patients presenting for surgical treatment: comparison to United States population norms and chronic disease states based on the EuroQuol-5 Dimensions Questionnaire","volume":"80","author":"Smith JS","year":"2017","unstructured":"Smith JS, Line B, Bess S,  The health impact of adult cervical deformity in patients presenting for surgical treatment: comparison to United States population norms and chronic disease states based on the EuroQuol-5 Dimensions Questionnaire. Neurosurgery. 2017;80(5):716\u2013725."},{"issue":"2","key":"b3","series-title":"Global Spine J","first-page":"846","article-title":"Adult cervical deformity patients have higher baseline frailty, disability, and comorbidities compared with complex adult thoracolumbar deformity patients: a comparative cohort study of 616 patients","volume":"15","author":"Smith JS","year":"2025","unstructured":"Smith JS, Kelly MP, Buell TJ,  Adult cervical deformity patients have higher baseline frailty, disability, and comorbidities compared with complex adult thoracolumbar deformity patients: a comparative cohort study of 616 patients. Global Spine J. 2025;15(2):846\u2013857."},{"issue":"2","key":"b4","series-title":"J Neurosurg Spine","first-page":"141","article-title":"Cervical spine alignment, sagittal deformity, and clinical implications: a review","volume":"19","author":"Scheer JK","year":"2013","unstructured":"Scheer JK, Tang JA, Smith JS,  Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine. 2013;19(2):141\u2013159."},{"issue":"3","key":"b5","series-title":"Neurospine","first-page":"506","article-title":"Prioritization of realignment associated with superior clinical outcomes for cervical deformity patients","volume":"18","author":"Pierce KE","year":"2021","unstructured":"Pierce KE, Passias PG, Brown AE,  Prioritization of realignment associated with superior clinical outcomes for cervical deformity patients. Neurospine. 2021;18(3):506\u2013514."},{"issue":"3","key":"b6","series-title":"J Neurosurg Spine","first-page":"309","article-title":"The gap between surgeon goal and achieved sagittal alignment in adult cervical spine deformity surgery","volume":"42","author":"Smith JS","year":"2025","unstructured":"Smith JS, Ben-Israel D, Kelly MP,  The gap between surgeon goal and achieved sagittal alignment in adult cervical spine deformity surgery. J Neurosurg Spine. 2025;42(3):309\u2013319."},{"issue":"4","key":"b7","series-title":"Neurosurgery","first-page":"559","article-title":"The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort","volume":"73","author":"Terran J","year":"2013","unstructured":"Terran J, Schwab F, Shaffrey CI,  The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort. Neurosurgery. 2013;73(4):559\u2013568."},{"issue":"23","key":"b8","series-title":"J Bone Joint Surg Am","first-page":"e48","article-title":"The T4-L1-hip axis: sagittal spinal realignment targets in long-construct adult spinal deformity surgery: early impact","volume":"106","author":"Hills J","year":"2024","unstructured":"Hills J, Mundis GM, Klineberg EO,  The T4-L1-hip axis: sagittal spinal realignment targets in long-construct adult spinal deformity surgery: early impact. J Bone Joint Surg Am. 2024;106(23):e48."},{"issue":"19","key":"b9","series-title":"Spine (Phila Pa 1976).","first-page":"1399","article-title":"The T4-L1-hip axis: defining a normal sagittal spinal alignment","volume":"47","author":"Hills J","year":"2022","unstructured":"Hills J, Lenke LG, Sardar ZM,  The T4-L1-hip axis: defining a normal sagittal spinal alignment. Spine (Phila Pa 1976).2022;47(19):1399\u20131406."},{"issue":"6","key":"b10","series-title":"J Neurosurg Spine","first-page":"673","article-title":"Reliability assessment of a novel cervical spine deformity classification system","volume":"23","author":"Ames CP","year":"2015","unstructured":"Ames CP, Smith JS, Eastlack R,  Reliability assessment of a novel cervical spine deformity classification system. J Neurosurg Spine. 2015;23(6):673\u2013683."},{"issue":"4","key":"b11","series-title":"J Neurosurg Spine","first-page":"441","article-title":"Establishing the minimum clinically important difference in Neck Disability Index and modified Japanese Orthopaedic Association scores for adult cervical deformity","volume":"33","author":"Soroceanu A","year":"2020","unstructured":"Soroceanu A, Smith JS, Lau D,  Establishing the minimum clinically important difference in Neck Disability Index and modified Japanese Orthopaedic Association scores for adult cervical deformity. J Neurosurg Spine. 2020;33(4):441\u2013445."},{"issue":"6","key":"b12","series-title":"Spine J","first-page":"968","article-title":"Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales","volume":"8","author":"Copay AG","year":"2008","unstructured":"Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY. Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J. 2008;8(6):968\u2013974."},{"issue":"24","key":"b13","series-title":"Spine (Phila Pa 1976).","first-page":"1685","article-title":"The conceptualization and derivation of the Cervical Lordosis Distribution Index","volume":"49","author":"Passias PG","year":"2024","unstructured":"Passias PG, Williamson TK, Dave P,  The conceptualization and derivation of the Cervical Lordosis Distribution Index. Spine (Phila Pa 1976).2024;49(24):1685\u20131691."},{"issue":"4","key":"b14","series-title":"Curr Rev Musculoskelet Med","first-page":"562","article-title":"The relationship between forward head posture and neck pain: a systematic review and meta-analysis","volume":"12","author":"Mahmoud NF","year":"2019","unstructured":"Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship between forward head posture and neck pain: a systematic review and meta-analysis. Curr Rev Musculoskelet Med. 2019;12(4):562\u2013577."},{"issue":"Suppl 1","key":"b15","series-title":"Neurosurgery","first-page":"S14-21","article-title":"The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery","volume":"76","author":"Tang JA","year":"2015","unstructured":"Tang JA, Scheer JK, Smith JS,  The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery. Neurosurgery. 2015;76Suppl 1:S14-21."},{"issue":"5","key":"b16","series-title":"J Neurosurg Spine","first-page":"849","article-title":"Comparison of frailty metrics and the Charlson Comorbidity Index for predicting adverse outcomes in patients undergoing surgery for spine metastases","volume":"36","author":"Hersh AM","year":"2022","unstructured":"Hersh AM, Pennington Z, Hung B,  Comparison of frailty metrics and the Charlson Comorbidity Index for predicting adverse outcomes in patients undergoing surgery for spine metastases. J Neurosurg Spine. 2022;36(5):849\u2013857."},{"key":"b17","series-title":"J Clin Neurosci","first-page":"23","article-title":"Utility of preoperative comorbidity burden on PROMIS outcomes after lumbar decompression: cohort matched analysis","volume":"121","author":"Roca AM","year":"2024","unstructured":"Roca AM, Anwar FN, Khosla I,  Utility of preoperative comorbidity burden on PROMIS outcomes after lumbar decompression: cohort matched analysis. J Clin Neurosci. 2024;121:23\u201327."},{"issue":"6","key":"b18","series-title":"Clin Spine Surg","first-page":"E294","article-title":"The impact of comorbidity burden on postoperative PROMIS physical function following minimally invasive transforaminal lumbar interbody fusion","volume":"33","author":"Parrish JM","year":"2020","unstructured":"Parrish JM, Jenkins NW, Hrynewycz NM, Brundage TS, Yoo JS, Singh K. The impact of comorbidity burden on postoperative PROMIS physical function following minimally invasive transforaminal lumbar interbody fusion. Clin Spine Surg. 2020;33(6):E294\u2013E298."},{"key":"b19","series-title":"World Neurosurg","first-page":"e157","article-title":"Severe comorbidity burden does not influence postoperative clinical outcomes and trajectory for back pain, leg pain, physical function, or disability in patients undergoing minimally invasive transforaminal lumbar interbody fusion: cohort-matched analysis","volume":"164","author":"Jacob KC","year":"2022","unstructured":"Jacob KC, Patel MR, Vanjani NN,  Severe comorbidity burden does not influence postoperative clinical outcomes and trajectory for back pain, leg pain, physical function, or disability in patients undergoing minimally invasive transforaminal lumbar interbody fusion: cohort-matched analysis. 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