The Influence of Surgical Intervention and Sagittal Alignment on Frailty in Adult Cervical Deformity

Frank A. Segreto; Peter Gust Passias; Avery E. Brown; Samantha R. Horn; Cole A. Bortz; Katherine E. Pierce; Haddy Alas; Virginie Lafage; Renaud Lafage; Justin S. Smith; Breton G. Line; Bassel G. Diebo; Michael P. Kelly; Gregory M. Mundis; Themistocles S. Protopsaltis; Alex Soroceanu; Han Jo Kim; Eric O. Klineberg; Douglas C. Burton; Robert A. Hart; Frank J. Schwab; Shay Bess; Christopher I. Shaffrey; Christopher P. Ames

doi:10.1093/ons/opz331

The Influence of Surgical Intervention and Sagittal Alignment on Frailty in Adult Cervical Deformity

Frank A. Segreto, Peter Gust Passias, Avery E. Brown, Samantha R. Horn, Cole A. Bortz, Katherine E. Pierce, Haddy Alas, Virginie Lafage, Renaud Lafage, Justin S. Smith, Breton G. Line, Bassel G. Diebo, Michael P. Kelly, Gregory M. Mundis, Themistocles S. Protopsaltis, Alex Soroceanu, Han Jo Kim, Eric O. Klineberg, Douglas C. Burton, Robert A. HartFrank J. Schwab, Shay Bess, Christopher I. Shaffrey, Christopher P. Ames

Orthopaedics and Rehabilitation

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

BACKGROUND: Frailty is a relatively new area of study for patients with cervical deformity (CD). As of yet, little is known of how operative intervention influences frailty status for patients with CD. OBJECTIVE: To investigate drivers of postoperative frailty score and variables within the cervical deformity frailty index (CD-FI) algorithm that have the greatest capacity for change following surgery. METHODS: Descriptive analysis of the cohort were performed, paired t-tests determined significant baseline to 1 yr improvements of factors comprising the CD-FI. Pearson bivariate correlations identified significant associations between postoperative changes in overall CD-FI score and CD-FI score components. Linear regression models determined the effect of successful surgical intervention on change in frailty score. RESULTS: A total of 138 patients were included with baseline frailty scores of 0.44. Following surgery, mean 1-yr frailty score was 0.27. Of the CD-FI variables, 13/40 (32.5%) were able to improve with surgery. Frailty improvement was found to significantly correlate with baseline to 1-yr change in CBV, PI-LL, PT, and SVA C7-S1. HRQL CD-FI components reading, feeling tired, feeling exhausted, and driving were the greatest drivers of change in frailty. Linear regression analysis determined successful surgical intervention and feeling exhausted to be the greatest significant predictors of postoperative change in overall frailty score. CONCLUSION: Complications, correction of sagittal alignment, and improving a patient's ability to read, drive, and chronic exhaustion can significantly influence postoperative frailty. This analysis is a step towards a greater understanding of the relationship between disability, frailty, and surgery in CD.

Original language	English (US)
Pages (from-to)	583-589
Number of pages	7
Journal	Operative Neurosurgery
Volume	18
Issue number	6
DOIs	https://doi.org/10.1093/ons/opz331
State	Published - Jun 1 2020

Keywords

Adult cervical deformity
Ames modifier
Cervical deformity frailty index
Frailty
Frailty drivers
Health-related quality of life
Postoperative frailty
Sagittal alignment
Surgical intervention
Surgical outcomes

ASJC Scopus subject areas

General Medicine

Access to Document

10.1093/ons/opz331

Cite this

Segreto, F. A., Passias, P. G., Brown, A. E., Horn, S. R., Bortz, C. A., Pierce, K. E., Alas, H., Lafage, V., Lafage, R., Smith, J. S., Line, B. G., Diebo, B. G., Kelly, M. P., Mundis, G. M., Protopsaltis, T. S., Soroceanu, A., Kim, H. J., Klineberg, E. O., Burton, D. C., ... Ames, C. P. (2020). The Influence of Surgical Intervention and Sagittal Alignment on Frailty in Adult Cervical Deformity. Operative Neurosurgery, 18(6), 583-589. https://doi.org/10.1093/ons/opz331

Segreto, FA, Passias, PG, Brown, AE, Horn, SR, Bortz, CA, Pierce, KE, Alas, H, Lafage, V, Lafage, R, Smith, JS, Line, BG, Diebo, BG, Kelly, MP, Mundis, GM, Protopsaltis, TS, Soroceanu, A, Kim, HJ, Klineberg, EO, Burton, DC, Hart, RA, Schwab, FJ, Bess, S, Shaffrey, CI & Ames, CP 2020, 'The Influence of Surgical Intervention and Sagittal Alignment on Frailty in Adult Cervical Deformity', Operative Neurosurgery, vol. 18, no. 6, pp. 583-589. https://doi.org/10.1093/ons/opz331

@article{7d1c6f401f6345c8a29529cf018df84b,

title = "The Influence of Surgical Intervention and Sagittal Alignment on Frailty in Adult Cervical Deformity",

abstract = "BACKGROUND: Frailty is a relatively new area of study for patients with cervical deformity (CD). As of yet, little is known of how operative intervention influences frailty status for patients with CD. OBJECTIVE: To investigate drivers of postoperative frailty score and variables within the cervical deformity frailty index (CD-FI) algorithm that have the greatest capacity for change following surgery. METHODS: Descriptive analysis of the cohort were performed, paired t-tests determined significant baseline to 1 yr improvements of factors comprising the CD-FI. Pearson bivariate correlations identified significant associations between postoperative changes in overall CD-FI score and CD-FI score components. Linear regression models determined the effect of successful surgical intervention on change in frailty score. RESULTS: A total of 138 patients were included with baseline frailty scores of 0.44. Following surgery, mean 1-yr frailty score was 0.27. Of the CD-FI variables, 13/40 (32.5%) were able to improve with surgery. Frailty improvement was found to significantly correlate with baseline to 1-yr change in CBV, PI-LL, PT, and SVA C7-S1. HRQL CD-FI components reading, feeling tired, feeling exhausted, and driving were the greatest drivers of change in frailty. Linear regression analysis determined successful surgical intervention and feeling exhausted to be the greatest significant predictors of postoperative change in overall frailty score. CONCLUSION: Complications, correction of sagittal alignment, and improving a patient's ability to read, drive, and chronic exhaustion can significantly influence postoperative frailty. This analysis is a step towards a greater understanding of the relationship between disability, frailty, and surgery in CD.",

keywords = "Adult cervical deformity, Ames modifier, Cervical deformity frailty index, Frailty, Frailty drivers, Health-related quality of life, Postoperative frailty, Sagittal alignment, Surgical intervention, Surgical outcomes",

author = "Segreto, {Frank A.} and Passias, {Peter Gust} and Brown, {Avery E.} and Horn, {Samantha R.} and Bortz, {Cole A.} and Pierce, {Katherine E.} and Haddy Alas and Virginie Lafage and Renaud Lafage and Smith, {Justin S.} and Line, {Breton G.} and Diebo, {Bassel G.} and Kelly, {Michael P.} and Mundis, {Gregory M.} and Protopsaltis, {Themistocles S.} and Alex Soroceanu and Kim, {Han Jo} and Klineberg, {Eric O.} and Burton, {Douglas C.} and Hart, {Robert A.} and Schwab, {Frank J.} and Shay Bess and Shaffrey, {Christopher I.} and Ames, {Christopher P.}",

note = "Publisher Copyright: {\textcopyright} 2019 by the Congress of Neurological Surgeons.",

year = "2020",

month = jun,

day = "1",

doi = "10.1093/ons/opz331",

language = "English (US)",

volume = "18",

pages = "583--589",

journal = "Operative Neurosurgery",

issn = "2332-4252",

publisher = "Lippincott Williams and Wilkins",

number = "6",

}

TY - JOUR

T1 - The Influence of Surgical Intervention and Sagittal Alignment on Frailty in Adult Cervical Deformity

AU - Segreto, Frank A.

AU - Passias, Peter Gust

AU - Brown, Avery E.

AU - Horn, Samantha R.

AU - Bortz, Cole A.

AU - Pierce, Katherine E.

AU - Alas, Haddy

AU - Lafage, Virginie

AU - Lafage, Renaud

AU - Smith, Justin S.

AU - Line, Breton G.

AU - Diebo, Bassel G.

AU - Kelly, Michael P.

AU - Mundis, Gregory M.

AU - Protopsaltis, Themistocles S.

AU - Soroceanu, Alex

AU - Kim, Han Jo

AU - Klineberg, Eric O.

AU - Burton, Douglas C.

AU - Hart, Robert A.

AU - Schwab, Frank J.

AU - Bess, Shay

AU - Shaffrey, Christopher I.

AU - Ames, Christopher P.

PY - 2020/6/1

Y1 - 2020/6/1

N2 - BACKGROUND: Frailty is a relatively new area of study for patients with cervical deformity (CD). As of yet, little is known of how operative intervention influences frailty status for patients with CD. OBJECTIVE: To investigate drivers of postoperative frailty score and variables within the cervical deformity frailty index (CD-FI) algorithm that have the greatest capacity for change following surgery. METHODS: Descriptive analysis of the cohort were performed, paired t-tests determined significant baseline to 1 yr improvements of factors comprising the CD-FI. Pearson bivariate correlations identified significant associations between postoperative changes in overall CD-FI score and CD-FI score components. Linear regression models determined the effect of successful surgical intervention on change in frailty score. RESULTS: A total of 138 patients were included with baseline frailty scores of 0.44. Following surgery, mean 1-yr frailty score was 0.27. Of the CD-FI variables, 13/40 (32.5%) were able to improve with surgery. Frailty improvement was found to significantly correlate with baseline to 1-yr change in CBV, PI-LL, PT, and SVA C7-S1. HRQL CD-FI components reading, feeling tired, feeling exhausted, and driving were the greatest drivers of change in frailty. Linear regression analysis determined successful surgical intervention and feeling exhausted to be the greatest significant predictors of postoperative change in overall frailty score. CONCLUSION: Complications, correction of sagittal alignment, and improving a patient's ability to read, drive, and chronic exhaustion can significantly influence postoperative frailty. This analysis is a step towards a greater understanding of the relationship between disability, frailty, and surgery in CD.

AB - BACKGROUND: Frailty is a relatively new area of study for patients with cervical deformity (CD). As of yet, little is known of how operative intervention influences frailty status for patients with CD. OBJECTIVE: To investigate drivers of postoperative frailty score and variables within the cervical deformity frailty index (CD-FI) algorithm that have the greatest capacity for change following surgery. METHODS: Descriptive analysis of the cohort were performed, paired t-tests determined significant baseline to 1 yr improvements of factors comprising the CD-FI. Pearson bivariate correlations identified significant associations between postoperative changes in overall CD-FI score and CD-FI score components. Linear regression models determined the effect of successful surgical intervention on change in frailty score. RESULTS: A total of 138 patients were included with baseline frailty scores of 0.44. Following surgery, mean 1-yr frailty score was 0.27. Of the CD-FI variables, 13/40 (32.5%) were able to improve with surgery. Frailty improvement was found to significantly correlate with baseline to 1-yr change in CBV, PI-LL, PT, and SVA C7-S1. HRQL CD-FI components reading, feeling tired, feeling exhausted, and driving were the greatest drivers of change in frailty. Linear regression analysis determined successful surgical intervention and feeling exhausted to be the greatest significant predictors of postoperative change in overall frailty score. CONCLUSION: Complications, correction of sagittal alignment, and improving a patient's ability to read, drive, and chronic exhaustion can significantly influence postoperative frailty. This analysis is a step towards a greater understanding of the relationship between disability, frailty, and surgery in CD.

KW - Adult cervical deformity

KW - Ames modifier

KW - Cervical deformity frailty index

KW - Frailty

KW - Frailty drivers

KW - Health-related quality of life

KW - Postoperative frailty

KW - Sagittal alignment

KW - Surgical intervention

KW - Surgical outcomes

UR - http://www.scopus.com/inward/record.url?scp=85084784215&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85084784215&partnerID=8YFLogxK

U2 - 10.1093/ons/opz331

DO - 10.1093/ons/opz331

M3 - Article

C2 - 31701155

AN - SCOPUS:85084784215

SN - 2332-4252

VL - 18

SP - 583

EP - 589

JO - Operative Neurosurgery

JF - Operative Neurosurgery

IS - 6

ER -

The Influence of Surgical Intervention and Sagittal Alignment on Frailty in Adult Cervical Deformity

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this