Evidence map›Paper›PMID 41452489›Full record

SynthesisNeurosurgical review2025

The influence of frailty on outcomes of adult spinal deformity surgery: A systematic review and meta-analysis.

Farhang Rashidi, Yatin Srinivash Ramesh Babu, Pouria Delbari, Mohammadmahdi Sabahi, Diego T Soto Rubio, Muhammad H Durrani, Fayyadh Yusuf, César Carballo Cuello, Hoon Choi, Daniel H Kim and 2 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Farhang RashidiDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Yatin Srinivash Ramesh BabuDr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.
Pouria DelbariDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Mohammadmahdi SabahiDepartment of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA.
Diego T Soto RubioDepartment of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Muhammad H DurraniDepartment of Neurosurgery, University of Texas Health at Houston, McGovern Medical School, Houston, TX, USA.
Fayyadh YusufDepartment of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
César Carballo CuelloDepartment of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Hoon ChoiDepartment of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA.
Daniel H KimDepartment of Neurosurgery, University of Texas Health at Houston, McGovern Medical School, Houston, TX, USA.
Alexander YuDepartment of Neurosurgery, Allegheny General Hospital, Pittsburgh, PA, USA.
Puya AlikhaniDepartment of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA. palikhan@usf.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose Adult spinal deformities (ASDs) pose a growing healthcare challenge due to their high prevalence and significant impact on quality of life. Although conservative management is often preferred initially, surgery becomes essential for patients with severe or unresponsive symptoms. However, surgical intervention in elderly populations introduces unique risks due to age-associated comorbidities and the complexity of spinal deformity correction. Recent evidence suggests that frailty could provide more accurate predictions of post-operative outcomes than chronological age alone, yet the exact role of frailty in ASD surgeries remains underexamined. This study aims to review the outcomes of ASD surgery in frail and non-frail population. Methods Following PRISMA guidelines, a systematic search was conducted across Embase, Scopus, Web of Science, and PubMed up until September 15th, 2024, using relevant key terms. The quality of studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS). Results Of 1,422 retrieved records, 19 studies met the inclusion criteria. This systematic review includes 17,473 patients aged 44 to 78 years, using different frailty indices, with follow-up ranging from two months to four years. There were no statistically significant differences regarding peri-operative metrics, such as duration of surgery, length of hospitalization, estimated blood loss, and reoperations between frail and non-frail patients. However, procedure-related complications (risk difference of 21%; 95% CI: 0.09, 0.33; p = 0.0008) were significantly higher in the frail group. In addition, there were no significant differences regarding biometric changes. The mean difference of Oswestry Disability Index and Scoliosis Research Society 22 questionnaire changes were not statistically significant in frail vs. non-frail patients. Conclusion Although frailty does not appear to substantially affect certain peri-operative metrics such as blood loss and length of hospitalization, it is associated with significantly higher complications. These findings underscore the need to consider frailty as a predictor of short-term surgical risk rather than long-term outcomes, highlighting the potential for a more nuanced approach in managing and counseling frail patients in this population.

Indexed as

FrailtyPostoperative ComplicationsSpinal CurvaturesAdultAgedHumansMiddle AgedQuality of LifeTreatment OutcomeAdult spinal deformityFrailtyMeta-analysisSpine surgerySystematic review

Identifiers

PMID41452489

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.