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Spine Surgery and Postoperative Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 352

Special Issue Editor


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Guest Editor
Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA
Interests: orthopaedic surgery; lumbar fusion; cervical disc arthroplasty

Special Issue Information

Dear Colleagues,

Modern spine surgery increasingly depends on optimized perioperative management to improve patient outcomes, reduce complications, and enhance recovery. This Special Issue focuses on the integration of surgical technique with evidence-based perioperative care across the preoperative, intraoperative, and postoperative phases of spine surgery. Areas of interest include patient optimization and risk stratification, anesthesia and neuromonitoring strategies, blood loss mitigation, infection prevention, multimodal and opioid-sparing analgesia, enhanced recovery after surgery (ERAS) pathways, postoperative mobilization, and strategies to improve patient-reported outcomes. Emphasis is placed on clinical trials, registry-based studies, and pragmatic perioperative protocols applicable to both degenerative and complex spinal pathology. By highlighting multidisciplinary collaboration among surgeons, anesthesiologists, and perioperative teams, this Special Issue aims to advance best practices that improve safety, efficiency, and value throughout the perioperative spine care continuum.

Dr. Mitchell K. Ng
Guest Editor

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Keywords

  • spine surgery
  • perioperative care
  • enhanced recovery after surgery (ERAS)
  • multimodal analgesia
  • opioid-sparing strategies
  • neuromonitoring
  • perioperative optimization

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Published Papers (1 paper)

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Research

15 pages, 914 KB  
Article
Frailty (mFI-5) and Age Predict Medical Complications After Posterior Lumbar Interbody Fusion in Older Adults: A Retrospective Cohort Study
by Jong-Hoon Jung, Jong-Hwan Hong, Ji-Ho Jung, Moon-Soo Han and Jung-Kil Lee
J. Clin. Med. 2026, 15(8), 2847; https://doi.org/10.3390/jcm15082847 - 9 Apr 2026
Viewed by 174
Abstract
Objective: To evaluate the prognostic utility of the five-item modified Frailty Index (mFI-5) for postoperative outcomes in older adults undergoing posterior lumbar interbody fusion (PLIF) for degenerative lumbar disease and to develop an interpretable preoperative risk model for medical complications (CxME). Methods [...] Read more.
Objective: To evaluate the prognostic utility of the five-item modified Frailty Index (mFI-5) for postoperative outcomes in older adults undergoing posterior lumbar interbody fusion (PLIF) for degenerative lumbar disease and to develop an interpretable preoperative risk model for medical complications (CxME). Methods: We retrospectively reviewed consecutive patients aged ≥65 years who underwent PLIF for lumbar spondylosis at a single tertiary institution. Baseline demographics, comorbidities, symptoms, American Society of Anesthesiologists (ASA) physical status, bone mineral density, antithrombotic use, perioperative laboratory findings, and operative variables were collected. CxME were defined as Clavien–Dindo grade ≥ II complications occurring during index hospitalization or within 30 days postoperatively. mFI-5 was calculated from five preoperative variables and stratified as 0, 1, and ≥2. Multivariable logistic regression was used to identify independent predictors of CxME. Results: Among 255 patients (mean age 72.6 years), 53 (20.8%) developed CxME. Patients with CxME were older and had higher rates of diabetes mellitus and preoperative dependency. mFI-5 ≥ 2 was more frequent in patients with CxME than in those without (66.0% vs. 27.3%, p < 0.001). Higher frailty was associated with older age, greater comorbidity burden, higher ASA class, lower preoperative hemoglobin, greater transfusion exposure, longer hospital stay, and a higher incidence of CxME (14.0%, 9.6%, and 38.9% for mFI-5 scores 0, 1, and ≥2, respectively; p < 0.001). In multivariable analysis, age (OR 1.133, 95% CI 1.055–1.216; p < 0.001) and mFI-5 (OR 2.103, 95% CI 1.387–3.188; p < 0.001) independently predicted CxME. The Age + mFI-5 model showed fair discrimination (optimism-corrected area under ROC 0.734). Conclusions: Preoperative frailty and age independently predicted postoperative medical complications after PLIF in older adults. The Age + mFI-5 model may support risk stratification, counselling, and perioperative optimization. Full article
(This article belongs to the Special Issue Spine Surgery and Postoperative Management)
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