Evidence map›Paper›PMID 42770149›Full record

ArticleNeurosurgery practice2026

Preoperative Frailty Predicts Mechanical Complications After Adult Spinal Deformity Surgery: A Retrospective Study.

Atef F Hulliel, Dana Saleh, Ahmad Zayd Alkadri, Vito Evola, Mohsen Rostami, Patrick Kim, Puya Alikhani

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Article in Neurosurgery practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Atef F HullielDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Dana SalehDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Ahmad Zayd AlkadriDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Vito EvolaDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Mohsen RostamiDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Patrick KimDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Puya AlikhaniDepartment of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesAdult spinal deformity (ASD) surgery is associated with high rates of mechanical complications, including rod fracture, pseudarthrosis, and implant failure. Although frailty has emerged as a superior predictor of adverse outcomes compared with chronological age or comorbidity burden alone, its specific relationship with long-term mechanical complications remains incompletely characterized. This study evaluated whether preoperative frailty independently predicts the development of mechanical complications after ASD surgery.

methodsThis retrospective cohort study included consecutive patients who underwent long-segment ASD corrective surgery with minimum 24-month radiographic follow-up. Frailty was assessed using the 5-item modified Frailty Index (mFI-5). The primary outcome was the occurrence of mechanical complications (rod fracture, pseudarthrosis, or implant loosening). Secondary outcomes included medical complications, estimated blood loss, and hospital length of stay. Multivariable logistic regression was performed to determine the independent association between frailty and mechanical complications.

resultsA total of 185 patients were included, of whom 55 were frail (mFI-5 ≥3) and 130 were nonfrail (mFI-5 <3). Frail patients had significantly higher rates of overall hardware failure (50.9% vs 33.1%,

conclusionPreoperative frailty is independently associated with mid- to long-term mechanical complications after ASD surgery. Routine incorporation of mFI-5 assessment into preoperative evaluation, combined with targeted bone-health optimization and frailty-adapted construct planning, may improve risk stratification and construct durability. Prospective multicenter studies are needed to validate whether multimodal interventions can reduce mechanical failure rates in frail patients.

Indexed as

Adult spinal deformityFrailtyMechanical complicationsModified Frailty IndexPseudarthrosisRod fractureSurgical outcomes

Identifiers

PMID42770149
PMCPMC13593264

What Socratic holds

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Registered trials

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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.