Cognitive Impairment Following Elective Spine Surgery

Kognitive Störungen Nach Elektiver Wirbelsäulenchirurgie Bei Älteren

Older people are a rapidly growing proportion of the world's population and their number is expected to increase twofold by 2050. When these people become patients that require surgery, they are at particular high risk for postoperative delirium (POD), which is associated with longer hospital stays, higher costs, risk for delayed complications and cognitive dysfunction (POCD). Having suffered an episode of delirium is furthermore a predictor of long-term care dependency. Despite these risks, an increasing number of elderly undergo major elective surgery. This is reflected by the frequency of elective spinal surgery, in general, and instrumented fusions, in particular, which has markedly increased over the past few decades.

It is yet insufficiently understood, which, particularly modifiable, factors contribute to the development of POD and POCD following these major but plannable surgeries. A better understanding of risk factors would facilitate informed patient decisions and surgical strategies could be tailored to individual risk profiles.

Inclusion Criteria:

• age ≥ 60 years
• scheduled for elective spine surgery without opening the dura
• patient can give informed consent him-/herself
• German native speaker

Exclusion Criteria:

• dementia or neurodegenerative disease
• psychiatric disease
• prescription of CNS-active medication (e.g. antidepressants, antipsychotics, sedatives, alpha-1-antagonists)
• impossible to participate in follow-up
• participation in an interventional trial
• electronic or displacable metallic implants
• active neoplasm