Bourassa-Moreau E, Versteeg A, Moskoven E, et al. - A single-institution, retrospective cohort study of 108 patients who underwent urgent surgery for spinal metastases from 2009 to 2015 was conducted in order to examine the ability of frailty and sarcopenia to independently prognosticate early mortality and adverse events (AEs) after urgent surgery for metastatic disease of the spine. At least one acute AE was present in 85% of patients. The occurrence of at least one postoperative AE was prognosticated by sarcopenia. Sarcopenia and the degree of neurological impairment were ominous of postoperative AE though the modified Frailty Index or Metastatic Frailty Index were not. Sarcopenia prognosticated 3-month mortality, independent of primary tumor type. Kaplan-Meyer analysis exhibited L3-TPA/VB and the Bollen Scale to significantly distinguish patient survival. Therefore, in patients undergoing urgent surgery for spinal metastasis, sarcopenia, easily covered by the L3-TPA/VB on conventional CT, prognosticates both early postoperative mortality and AEs, hence, giving a practical tool for timely therapeutic decision-making in this complex patient population.