Turkish Neurosurgery
Does Surgery for Adult Spinal Deformity Affect the Cognitive Abilities in Patients over 50 years of Age?
Vugar Nabiyev1, Selim Ayhan1, Selcen Yuksel2, Asli Niyazi3, Tiro Mmopelwa1, Montse Domingo-Sabat4, Alba Vila-Casademunt4, Ferran Pellise4, Ahmet Alanay5, Francisco J. Sanchez Perez-Grueso6, Frank Kleinstück7, Ibrahim Obeid8, Emre Acaroglu1, European Spine Study Group4
1Acibadem ARTES Spine Center, Spine and Spinal Cord Surgery, Ankara,
2Yildirim Beyazit University, Biostatistics, Ankara,
3Middle East Technical University, Psychology, Mersin 10,
4Hospital Universitari Vall d’Hebron, Spinal Unit, Barcelona,
5Acibadem Maslak Hospital, Comprehensive Spine Center, Istanbul,
6Hospital Universitari La Paz, Spine Unit, Madrid,
7Schultess Clinic, Musculoskletal Center, Zurich,
8Bordeaux University Hospital, Spine Surgery, Bordeaux,
DOI: 10.5137/1019-5149.JTN.18285-16.1
Aim:To analyze the cognitive abilities of older patients undergoing spinal deformity surgery so as to understand whether adult spinal deformity (ASD) surgery is associated with postoperative cognitive malfunction.Material and Methods:A prospective longitudinal study was performed on surgical patients older than 50 years, enrolled in a prospective multicenter database. Mini-mental state examination (MMSE) was performed to assess cognitive function in addition to the HRQOL tests; (SF-36, ODI and SRS-22) at pre-operative, post-operative 6 weeks and 6 months points. Demographics, preoperative health status, co-morbidities and surgical characteristics were also analyzed. Descriptive statistics and repeated measures of variance analysis were performed.Results:A total of 90 patients with a mean age of 67.4±8.2 were enrolled in the study; all had MMSE evaluations at 6 weeks follow-up and 58 patients had both 6 weeks and 6 months follow-up. Average(SD) surgical time, estimated blood loss, number of levelsfused and hospital stay were 240.1(111.9), 1621.2(1058.7), 11.2(4.4) and 14.2(11.45), respectively. On analysis, a slight increase in mean MMSE score (p>0.05) between time points was found despite decreases of >2points (3 or 4) in 6 patients (6.7%) at both time points.Conclusion:Although ASD surgery in older patients is recognized as challenging, this study suggests that it is not necessarily associated with a significant deterioration in the cognitive abilities of patients undergoing surgery. This may be due to the relatively minor influence of ASD itself on the cognitive abilities of the patients involved as well as to the relatively stable hemodynamic conditions obtainable during modern ASD surgery.
Corresponding author : Emre Acaroglu