{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:36:35Z","timestamp":1789799795981,"version":"4.0.1"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Postlaminoplasty kyphotic deformity (PKD) is a complication affecting roughly 20% of patients undergoing cervical laminoplasty. Identification of preoperative risk factors for PKD could allow surgeons to adapt treatment plans to reduce PKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the ability of the Charlson Comorbidity Index (CCI), 5-item Modified Frailty Index (5i-mFi), and Administrative Risk Analysis Index (RAI-A) to predict for the development of PKD in patients with cervical spondylotic myelopathy (CSM) undergoing laminoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed CSM patients who underwent laminoplasty at an academic tertiary care center between January 1, 2016, and January 30, 2022, and had a complete set of anterolateral cervical X-rays at 1-year follow-up. Angular kyphosis was defined as the loss of cervical lordosis by more than \u2212 10\u00b0 after surgery when measuring the difference between pre- and post-operative C2-7 Cobb angles. Regression and receiver operating characteristic (ROC) curve analysis were used to assess the ability of the frailty assessments to predict for PKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seventy-six CMS patients were eligible, 11.8% of which developed PKD. The cohort consisted of 54 males and 22 females with a mean age of 59.5 years and body mass index of 29.2 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . No CCI, 59-mFi, or RAI-A frailty subgroup was associated with kyphotic development and ROC curve analysis showed that neither CCI (P = 0.81), 5i-mFi (P = 0.59), nor RAI-A (P = 0.63) predicted for PKD. None of these assessments were a superior prognosticator of PKD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>CCI, 5i-mFi, and RAI-A frailty assessments were not associated with the development of PKD in CSM patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_204_24","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T14:00:57Z","timestamp":1751551257000},"page":"148-156","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Frailty index as predictors of loss of cervical lordosis following laminoplasty in patients with cervical spondylotic myelopathy"],"prefix":"10.4103","volume":"16","author":[{"given":"Michael Ryan","family":"Kann","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel A.","family":"Ruiz-Cardozo","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karma","family":"Barot","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan","family":"Joseph","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Bui","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Yakdan","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Brehm","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Trevino","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Carey-Ewend","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Olufawo","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander Thomas","family":"Yahanda","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenton","family":"Pennicooke","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo A.","family":"Molina","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Washington University School of Medicine, Saint Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"R1-20250707","doi-asserted-by":"crossref","first-page":"163","DOI":"10.4103\/jcvjs.JCVJS_70_20","article-title":"Factors predicting loss of cervical lordosis following cervical laminoplasty:A critical review","volume":"11","author":"Alam","year":"2020","journal-title":"J Craniovertebr Junction Spine"},{"key":"R2-20250707","doi-asserted-by":"crossref","first-page":"147","DOI":"10.25259\/SNI_339_2019","article-title":"Which factors predict the loss of cervical lordosis following cervical laminoplasty?A review of various indices and their clinical implications","volume":"10","author":"Sharma","year":"2019","journal-title":"Surg Neurol Int"},{"key":"R3-20250707","first-page":"230","article-title":"Cervical laminoplasty:A critical review","volume":"98","author":"Ratliff","year":"2003","journal-title":"J Neurosurg"},{"key":"R4-20250707","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1038\/sj.sc.3100749","article-title":"Analysis of the cervical spine alignment following laminoplasty and laminectomy","volume":"37","author":"Matsunaga","year":"1999","journal-title":"Spinal Cord"},{"key":"R5-20250707","doi-asserted-by":"crossref","first-page":"790593","DOI":"10.3389\/fsurg.2021.790593","article-title":"Comparison of laminoplasty versus laminectomy for cervical spondylotic myelopathy:A systematic review and meta-analysis","volume":"8","author":"Zhao","year":"2021","journal-title":"Front Surg"},{"key":"R6-20250707","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1097\/01.blo.0000069889.31220.62","article-title":"Minimum 10-Year Followup After En Bloc Cervical Laminoplasty","volume":"411","author":"Kawaguchi","year":"2003","journal-title":"Clinical Orthopaedics and Related Research\u00ae"},{"issue":"Suppl 2","key":"R7-20250707","first-page":"229","article-title":"Long-term follow-up of clinical and radiological outcome after cervical laminectomy","volume":"24","author":"van","year":"2015","journal-title":"Eur Spine J"},{"key":"R8-20250707","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1097\/00007632-200103010-00010","article-title":"Long-term results of double-door laminoplasty for cervical stenotic myelopathy","volume":"26","author":"Seichi","year":"2001","journal-title":"Spine (Phila Pa 1976)"},{"key":"R9-20250707","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1227\/NEU.0b013e31823cf16b","article-title":"Cervical laminectomy versus laminoplasty:Is there a difference in outcome and postoperative pain?","volume":"70","author":"Nurboja","year":"2012","journal-title":"Neurosurgery"},{"key":"R10-20250707","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3171\/2022.4.SPINE22182","article-title":"Predictors for cervical kyphotic deformity following laminoplasty:A systematic review and meta-analysis","volume":"38","author":"Pettersson","year":"2023","journal-title":"J Neurosurg Spine"},{"key":"R11-20250707","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3171\/2013.4.SPINE12838","article-title":"Cervical spine alignment, sagittal deformity, and clinical implications:A review","volume":"19","author":"Scheer","year":"2013","journal-title":"J Neurosurg Spine"},{"key":"R12-20250707","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1227\/NEU.0b013e31826100c9","article-title":"The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery","volume":"71","author":"Tang","year":"2012","journal-title":"Neurosurgery"},{"key":"R13-20250707","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s12877-016-0329-8","article-title":"Frailty and post-operative outcomes in older surgical patients:A systematic review","volume":"16","author":"Lin","year":"2016","journal-title":"BMC Geriatr"},{"key":"R14-20250707","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.amjsurg.2018.11.020","article-title":"Impact of frailty on outcomes in surgical patients:A systematic review and meta-analysis","volume":"218","author":"Panayi","year":"2019","journal-title":"Am J Surg"},{"key":"R15-20250707","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/j.spinee.2022.01.017","article-title":"Which frailty scales for patients with adult spinal deformity are feasible and adequate?A systematic review","volume":"22","author":"Kitamura","year":"2022","journal-title":"Spine J"},{"key":"R16-20250707","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.ejim.2016.03.007","article-title":"Frailty measurement in research and clinical practice:A review","volume":"31","author":"Dent","year":"2016","journal-title":"Eur J Intern Med"},{"key":"R17-20250707","doi-asserted-by":"crossref","first-page":"625","DOI":"10.14336\/AD.2020.0904","article-title":"The impact of frailty on spine surgery:Systematic review on 10 years clinical studies","volume":"12","author":"Veronesi","year":"2021","journal-title":"Aging Dis"},{"key":"R18-20250707","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/j.spinee.2021.01.028","article-title":"Frailty adversely affects outcomes of patients undergoing spine surgery:A systematic review","volume":"21","author":"Chan","year":"2021","journal-title":"Spine J"},{"key":"R19-20250707","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies:Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"R20-20250707","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jss.2013.01.021","article-title":"Accumulating deficits model of frailty and postoperative mortality and morbidity:Its application to a national database","volume":"183","author":"Velanovich","year":"2013","journal-title":"J Surg Res"},{"key":"R21-20250707","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1001\/jamasurg.2016.4202","article-title":"Development and initial validation of the risk analysis index for measuring frailty in surgical populations","volume":"152","author":"Hall","year":"2017","journal-title":"JAMA Surg"},{"key":"R22-20250707","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.spinee.2015.10.042","article-title":"Relationship between T1 slope and loss of lordosis after laminoplasty in patients with cervical ossification of the posterior longitudinal ligament","volume":"16","author":"Kim","year":"2016","journal-title":"Spine J"},{"key":"R23-20250707","doi-asserted-by":"crossref","first-page":"E456","DOI":"10.1097\/BRS.0000000000002887","article-title":"Does extension dysfunction affect postoperative loss of cervical lordosis in patients who undergo laminoplasty?","volume":"44","author":"Lee","year":"2019","journal-title":"Spine (Phila Pa 1976)"},{"key":"R24-20250707","doi-asserted-by":"crossref","first-page":"E992","DOI":"10.1097\/BRS.0b013e3182972e1b","article-title":"T1 slope as a predictor of kyphotic alignment change after laminoplasty in patients with cervical myelopathy","volume":"38","author":"Kim","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"R25-20250707","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement:Guidelines for reporting observational studies","volume":"335","author":"von","year":"2007","journal-title":"BMJ"},{"key":"R26-20250707","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1631\/jzus.B1300109","article-title":"Charlson comorbidity index helps predict the risk of mortality for patients with type 2 diabetic nephropathy","volume":"15","author":"Huang","year":"2014","journal-title":"J Zhejiang Univ Sci B"},{"key":"R27-20250707","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.14245\/ns.2244326.163","article-title":"Risk analysis index and its recalibrated version predict postoperative outcomes better than 5-factor modified frailty index in traumatic spinal injury","volume":"19","author":"Conlon","year":"2022","journal-title":"Neurospine"},{"key":"R28-20250707","doi-asserted-by":"crossref","first-page":"567","DOI":"10.2106\/JBJS.I.00003","article-title":"Mortality in elderly patients after cervical spine fractures","volume":"92","author":"Harris","year":"2010","journal-title":"J Bone Joint Surg Am"},{"key":"R29-20250707","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1186\/s13018-021-02377-7","article-title":"Charlson comorbidity index is predictive of postoperative clinical outcome after single-level posterior lumbar interbody fusion surgery","volume":"16","author":"Shinonara","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"R30-20250707","doi-asserted-by":"crossref","first-page":"E1274","DOI":"10.1097\/BRS.0b013e318206cda3","article-title":"Charlson score is a robust predictor of 30-day complications following spinal metastasis surgery","volume":"36","author":"Arrigo","year":"2011","journal-title":"Spine (Phila Pa 1976)"},{"key":"R31-20250707","doi-asserted-by":"crossref","first-page":"e1058","DOI":"10.1016\/j.wneu.2022.05.101","article-title":"Assessment of frailty indices and Charlson comorbidity index for predicting adverse outcomes in patients undergoing surgery for spine metastases:A national database analysis","volume":"164","author":"Elsamadicy","year":"2022","journal-title":"World Neurosurg"},{"key":"R32-20250707","doi-asserted-by":"crossref","first-page":"106697","DOI":"10.1016\/j.clineuro.2021.106697","article-title":"Charlson comorbidity index score predicts adverse post-operative outcomes after far lateral lumbar discectomy","volume":"206","author":"Borja","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"R33-20250707","doi-asserted-by":"crossref","first-page":"e626","DOI":"10.1016\/j.wneu.2018.12.168","article-title":"The modified 5-item frailty index:A concise and useful tool for assessing the impact of frailty on postoperative morbidity following elective posterior lumbar fusions","volume":"124","author":"Weaver","year":"2019","journal-title":"World Neurosurg"},{"key":"R34-20250707","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1177\/21925682221124101","article-title":"Utility of the Modified 5-Items Frailty Index to Predict Complications and Mortality After Elective Cervical, Thoracic and Lumbar Posterior Spine Fusion Surgery:Multicentric Analysis From ACS-NSQIP Database","volume":"14","author":"Camino-Willhuber","year":"2022","journal-title":"Global Spine Journal"},{"key":"R35-20250707","doi-asserted-by":"crossref","first-page":"E1083","DOI":"10.1097\/BRS.0000000000003063","article-title":"The 5-item modified frailty index is predictive of severe adverse events in patients undergoing surgery for adult spinal deformity","volume":"44","author":"Yagi","year":"2019","journal-title":"Spine (Phila Pa 1976)"},{"key":"R36-20250707","doi-asserted-by":"crossref","first-page":"e670","DOI":"10.1016\/j.wneu.2020.10.154","article-title":"Utility of the 5-item modified frailty index for predicting adverse outcomes following elective anterior cervical discectomy and fusion","volume":"146","author":"Zreik","year":"2021","journal-title":"World Neurosurg"},{"key":"R37-20250707","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.spinee.2022.12.014","article-title":"Frailty measured by risk analysis index and adverse discharge outcomes after adult spine deformity surgery:Analysis of 3104 patients from a prospective surgical registry (2011-2020)","volume":"23","author":"Covell","year":"2023","journal-title":"Spine J"},{"key":"R38-20250707","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s11060-022-04135-z","article-title":"Preoperative frailty measured by risk analysis index predicts complications and poor discharge outcomes after brain tumor resection in a large multi-center analysis","volume":"160","author":"Thommen","year":"2022","journal-title":"J Neurooncol"},{"key":"R39-20250707","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.spinee.2017.05.028","article-title":"Discriminative ability of commonly used indices to predict adverse outcomes after poster lumbar fusion:A comparison of demographics, ASA, the modified Charlson comorbidity index, and the modified frailty index","volume":"18","author":"Ondeck","year":"2018","journal-title":"Spine J"},{"key":"R40-20250707","doi-asserted-by":"crossref","first-page":"770","DOI":"10.14444\/8099","article-title":"Charlson comorbidity index:An inaccurate predictor of minimally invasive lumbar spinal fusion outcomes","volume":"15","author":"Jenkins","year":"2021","journal-title":"Int J Spine Surg"},{"key":"R41-20250707","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1016\/j.spinee.2021.05.011","article-title":"Modified-frailty index does not independently predict complications, hospital length of stay or 30-day readmission rates following posterior lumbar decompression and fusion for spondylolisthesis","volume":"21","author":"Elsamadicy","year":"2021","journal-title":"Spine J"},{"key":"R42-20250707","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1227\/neu.0000000000002439","article-title":"Frailty measured by the risk analysis index predicts nonhome discharge and mortality after resection in refractory epilepsy:Analysis of 1236 patients from a prospective surgical registry, 2012 to 2020","volume":"93","author":"Estes","year":"2023","journal-title":"Neurosurgery"},{"key":"R43-20250707","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1093\/neuros\/nyaa468","article-title":"Impact of frailty on outcomes following spine surgery:A prospective cohort analysis of 668 patients","volume":"88","author":"Agarwal","year":"2021","journal-title":"Neurosurgery"},{"key":"R44-20250707","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1055\/a-2015-1162","article-title":"Risk analysis index and 30-day mortality after brain tumor resection:A multicenter frailty analysis of 31,776 patients from, 2012 to 2020","volume":"85","author":"Rumalla","year":"2024","journal-title":"J Neurol Surg B Skull Base"}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_204_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:55:12Z","timestamp":1786647312000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_204_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":44,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_204_24","relation":{},"ISSN":["0974-8237","0976-9285"],"issn-type":[{"value":"0974-8237","type":"print"},{"value":"0976-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-12-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}