Evidence map›Paper›PMID 40790108›Full record

ArticleSpine deformity2025

Association between preoperative activity levels and postoperative complications in adult spinal deformity surgery.

Rohit Bhan, Salim Yakdan, Christopher Diaz, Jingwen Zhang, Ziqi Xu, Karan Joseph, Benjamin Plog, Alexander T Yahanda, Justin K Zhang, Saad Javeed and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

16 authors.

Rohit Bhan *Department of Orthopedic Surgery, Washington University, St. Louis, MO, USA.
Salim Yakdan *Department of Neurological Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8057, St. Louis, MO, 63110, USA.ORCID http://orcid.org/0009-0003-0109-5013
Christopher DiazDepartment of Orthopedic Surgery, Washington University, St. Louis, MO, USA.
Jingwen ZhangDepartment of Computer Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA.
Ziqi XuDepartment of Computer Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA.
Karan JosephDepartment of Neurological Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8057, St. Louis, MO, 63110, USA.
Benjamin PlogDepartment of Neurological Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8057, St. Louis, MO, 63110, USA.
Alexander T YahandaDepartment of Neurological Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8057, St. Louis, MO, 63110, USA.
Justin K ZhangDepartment of Neurological Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8057, St. Louis, MO, 63110, USA.
Saad JaveedDepartment of Neurological Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8057, St. Louis, MO, 63110, USA.
Wilson Z RayDepartment of Neurological Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8057, St. Louis, MO, 63110, USA.
Munish GuptaDepartment of Orthopedic Surgery, Washington University, St. Louis, MO, USA.
Chenyang LuDepartment of Computer Science and Engineering, Washington University in St. Louis, St. Louis, MO, USA.
Michael P KellyDepartment of Orthopedic Surgery, Rady Children's Hospital, University of California, San Diego, CA, USA.
Jacob K Greenberg *Department of Neurological Surgery, Washington University, 660 S. Euclid Ave, Campus Box 8057, St. Louis, MO, 63110, USA. jacobgreenberg@wustl.edu.
Brian Neuman *Department of Orthopedic Surgery, Washington University, St. Louis, MO, USA.

Funding

Using Mobile Health Technology and Real-Time Assessments to Address Multilevel Influences on Lumbar Spine Surgery OutcomesK23AR082986 · NIAMS · WASHINGTON UNIVERSITY · PI JACOB GREENBERG · 2024 to 2026
$515k
NIAMS NIH HHS 1K23AR082986-01A1NIAMS NIH HHS K23 AR082986NIMH NIH HHS 1F31MH124291-01A
6 · The paper itself

Abstract

purposeAdult spinal deformity (ASD) is a condition associated with significant pain, disability, and high complication rates after surgery, reaching 38-71%. These complications significantly impact recovery, which often takes over a year. Efforts to mitigate complications have focused on preoperative risk stratification using factors such as frailty and patient demographics. Emerging evidence suggests that preoperative mobility and targeted interventions, such as prehabilitation programs, may improve surgical outcomes. This study evaluates the relationship between preoperative activity levels, measured through wearable device, and postoperative complications in ASD surgery.

methodsThis was a prospective cohort study including patients aged 21-85 years undergoing surgery for ASD. Participants were passively monitored before surgery using Fitbit trackers. Raw Fitbit data were extracted at the minute level and underwent feature engineering to derive meaningful clinical metrics. Activity features included activity amount (i.e. step count) and activity intensity (i.e. peak 30-min cadence) measures. Patients' characteristics and postoperative complications were extracted from Electronic Health Records. A Mann-Whitney U test was used to assess differences in activity metrics between patients with and without complications.

resultsA total of 23 ASD patients were enrolled, with an average age of 66.6 years and an average of 10.4 fusion levels. All patients were fused to the pelvis, with 35% (8 patients) experiencing perioperative complications and 13% readmitted within 30 days. Complications included DVT, AKI, SSI, wound dehiscence, and reoperation. Patients with higher preoperative activity levels, demonstrated fewer complications. Significant differences were observed between patients with complications and those without in several activity metrics, including steps per activity bout (44.5 vs. 81.0; p = 0.017), active time per bout (1.78 vs. 2.59; p = 0.028), steps per minute of activity (23.5 vs. 29.1; p = 0.02), and maximum 30-min cadence (40.1 vs. 58.6; p = 0.04).

conclusionIncreased preoperative activity levels is associated with reduced complications after ASD surgery. Larger studies are needed to validate these findings, identify critical activity metrics, and establish thresholds for optimizing outcomes. These results highlight the potential benefits of prehabilitation in improving surgical outcomes for ASD patients.

Indexed as

Postoperative ComplicationsPreoperative ExerciseSpinal CurvaturesAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedProspective StudiesSpinal FusionYoung AdultAdult spinal deformityFitbitPerioperative complicationsPreoperative mobilitySpine surgeryWearable devices

Identifiers

PMID40790108
PMCPMC13110061

What OpenQuestion 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 OpenQuestion graph.