Online Sustained-Attention Testing as an Adjunct Outcome Measure in Personalized Spine Surgery Research: A Study Protocol and Methodological Framework Using the 90-Second CVAT

Background/Objectives: This protocol article presents a methodological framework and does not itself report a new validation dataset. Personalized spine surgery increasingly requires outcome measures that capture recovery domains beyond pain, disability, imaging, neurological status, complications, and revision surgery. Sustained-attention instability may reflect pain-related cognitive burden and may influence rehabilitation adherence, work capacity, medication management, and postoperative self-care. Building on published CVAT evidence and additional unpublished findings from a completed independent online known-groups cohort, this protocol article specifies a standardized framework for integrating the online 90 s Continuous Visual Attention Test (CVAT) into personalized spine surgery research.