LATEBREAKER
Neurology
Impact of Preoperative Frailty and/or Sarcopenia on Postoperative Outcomes in Adults with Degenerative Cervical Myelopathy. Hussein Samhat* Hussein Samhat Karlo M. Pedro Genevieve Gore Kristian B. Filion Raphaële Charest-Morin Oliver Lasry
Introduction: Degenerative Cervical Myelopathy (DCM) is the leading cause of non-traumatic spinal cord dysfunction in adults worldwide, causing spinal cord compression with symptoms ranging from neck stiffness to severe neurological deficits. Surgical intervention to decompress and stabilize the cervical spine is the mainstay treatment. However, surgery has inherent risks and results in heterogeneous outcomes. This highlights the need for effective risk stratification. Frailty (diminished physiological reserve) and sarcopenia (loss of muscle mass and function) are emerging risk-stratification tools, yet their roles in DCM outcomes remain unclear. This systematic review investigates the association between frailty/sarcopenia and post-operative outcomes in adult patients undergoing surgery for DCM.
Methods: We conducted a systematic search across eight databases (Figure 1), adhering to our comprehensive criteria (Table 1) outlined in the PROSPERO protocol (CRD42024477896). Screening, data extraction, and risk of bias via RoBANS-2, were performed by two independent reviewers.
Results: After screening 3,937 manuscripts, 14 met the inclusion criteria — nine addressing frailty and five focusing on sarcopenia. Preliminary findings show higher frailty levels consistently associated with increased post-operative complications, extended hospital stays, frequent non-routine discharges, and increased healthcare costs. Similarly, sarcopenia was associated with poorer spinal alignment, reduced functional outcomes, and lower patient satisfaction after surgery. These relationships held true across diverse patient demographics and hospital settings.
Conclusion: This review establishes the importance of frailty and sarcopenia assessments in preoperative evaluation for DCM, offering critical insights for surgical risk prediction. Integrating these assessments into clinical decision-making can inform personalized care and potentially optimize post-surgical recovery in DCM.
