Frailty index as predictors of loss of cervical lordosis following laminoplasty in patients with cervical spondylotic myelopathy.

BACKGROUND

Postlaminoplasty kyphotic deformity (PKD) is a complication affecting roughly 20% of patients undergoing cervical laminoplasty. Identification of preoperative risk factors for PKD could allow surgeons to adapt treatment plans to reduce PKD.

OBJECTIVE

The aim of this study was to investigate the ability of the Charlson Comorbidity Index (CCI), 5-item Modified Frailty Index (5i-mFi), and Administrative Risk Analysis Index (RAI-A) to predict for the development of PKD in patients with cervical spondylotic myelopathy (CSM) undergoing laminoplasty.

MATERIALS AND

METHODS

We retrospectively reviewed CSM patients who underwent laminoplasty at an academic tertiary care center between January 1, 2016, and January 30, 2022, and had a complete set of anterolateral cervical X-rays at 1-year follow-up. Angular kyphosis was defined as the loss of cervical lordosis by more than - 10° after surgery when measuring the difference between pre- and post-operative C2-7 Cobb angles. Regression and receiver operating characteristic (ROC) curve analysis were used to assess the ability of the frailty assessments to predict for PKD.

RESULTS

Seventy-six CMS patients were eligible, 11.8% of which developed PKD. The cohort consisted of 54 males and 22 females with a mean age of 59.5 years and body mass index of 29.2 kg/m2. No CCI, 59-mFi, or RAI-A frailty subgroup was associated with kyphotic development and ROC curve analysis showed that neither CCI (P = 0.81), 5i-mFi (P = 0.59), nor RAI-A (P = 0.63) predicted for PKD. None of these assessments were a superior prognosticator of PKD.

CONCLUSION

CCI, 5i-mFi, and RAI-A frailty assessments were not associated with the development of PKD in CSM patients.