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

  • 0Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Journal of Craniovertebral Junction & Spine +

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August 4, 2025

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August 4, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Preoperative frailty indices like CCI, 5i-mFi, and RAI-A do not predict post-laminoplasty kyphotic deformity (PKD) in cervical spondylotic myelopathy patients. These common assessments are not useful for identifying patients at risk for this complication.

Area Of Science

  • Neurosurgery
  • Orthopedic Surgery
  • Geriatric Medicine

Background

  • Postlaminoplasty kyphotic deformity (PKD) is a significant complication following cervical laminoplasty, impacting approximately 20% of patients.
  • Identifying preoperative risk factors for PKD is crucial for tailoring surgical strategies and mitigating potential adverse outcomes.

Purpose Of The Study

  • To evaluate the predictive capability of the Charlson Comorbidity Index (CCI), 5-item Modified Frailty Index (5i-mFi), and Administrative Risk Analysis Index (RAI-A) for the development of PKD.
  • To determine if these established frailty assessments can identify patients undergoing laminoplasty for cervical spondylotic myelopathy (CSM) at higher risk for kyphotic deformity.

Main Methods

  • Retrospective review of CSM patients who underwent laminoplasty between 2016 and 2022.
  • Measurement of C2-7 Cobb angles from anterolateral cervical X-rays at 1-year follow-up to define angular kyphosis (loss of lordosis > -10°).
  • Statistical analysis using regression and receiver operating characteristic (ROC) curve analysis to assess the predictive value of CCI, 5i-mFi, and RAI-A for PKD.

Main Results

  • A total of 76 CSM patients were analyzed, with 11.8% developing PKD.
  • No significant association was found between CCI, 5i-mFi, or RAI-A frailty subgroups and the development of kyphotic deformity.
  • ROC curve analysis indicated that CCI (P = 0.81), 5i-mFi (P = 0.59), and RAI-A (P = 0.63) did not reliably predict PKD.

Conclusions

  • The study concludes that CCI, 5i-mFi, and RAI-A frailty assessments are not associated with the development of postlaminoplasty kyphotic deformity in CSM patients.
  • These commonly used frailty indices do not serve as effective prognosticators for PKD after cervical laminoplasty.

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