Related Experiment Video
Updated: Jun 13, 2025
05:30
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
759
Postoperative Delirium Following Posterior Lumbar Spinal Fusion: Epidemiology, Risk Factors, and Associated
Ashley Knebel1, Manjot Singh1, Rhea Rasquinha1
1Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
World Neurosurgery
|September 13, 2024
Summary
Postoperative delirium (POD) affects nearly 0.5% of posterior spinal fusion patients, decreasing over time. POD is linked to electrolyte disturbances and increased complications in elderly patients.
Area of Science:
- Spinal Surgery
- Geriatric Medicine
- Neuroscience
Background:
- Postoperative delirium (POD) is a common complication in elderly patients undergoing major surgery.
- Identified risk factors for POD include advanced age, surgical complexity, and pre-existing comorbidities.
Purpose of the Study:
- To analyze trends in POD incidence and associated factors in posterior lumbar fusion patients.
- To investigate the relationship between POD, electrolyte disturbances, and 90-day postoperative complications.
Main Methods:
- Retrospective analysis of posterior lumbar fusion patients using PearlDiver database.
- Patients were stratified into POD and no-POD cohorts within 7 days of surgery.
- Epidemiological, comparative, and matched analyses were performed on demographics, cognitive status, electrolyte levels, and complications.
Main Results:
- POD incidence decreased from 0.7% in 2010 to 0.4% in 2022, increasing with patient age.
- POD patients exhibited higher rates of baseline cognitive impairment, hypernatremia, and hypocalcemia.
- POD was associated with longer hospital stays, increased 90-day costs, and higher rates of postoperative complications.
Conclusions:
- The incidence of POD in posterior spinal fusion patients has declined but remains a concern, particularly in older individuals.
- Electrolyte disturbances and multilevel fusions are associated with POD.
- Mitigating POD consequences in spine surgery patients requires continued intervention strategies.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
58
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
58
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
592
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
592