The impact of frailty and sarcopenia on patient outcomes after complex spine surgery.

Abstract

Frailty and sarcopenia represent a state of increased fragility and decreased reserve, and both have been associated with worse outcomes after surgery. The present review focuses on the definitions and measurement tools used to assess frailty and sarcopenia in patients with spinal disorder, and the relationships between frailty, sarcopenia, and postoperative outcomes in patients undergoing complex spine surgery. Complex spine surgery is associated with a high rate of adverse events when using a validated, prospective data collection system. Recent studies have demonstrated that patients with spine surgery with frailty and sarcopenia have a higher risk of adverse events, although this relationship varies depending on the measurement tool and specific population studied. Both general and specific frailty assessment tools have been used in the spine surgery population, however the optimal tool is not known. Spinal disorders such as lumbar stenosis contribute to the frailty phenotype, and may be reversible with surgery. Frailty and sarcopenia are increasingly recognized as important predictors of adverse outcomes after complex spine surgery. The optimal tool to measure frailty and sarcopenia in patients with spinal disorders remains unclear, and the role of surgery as an intervention to reverse frailty requires further investigation.