Key result
Laminoplasty was associated with a significantly higher incidence of postoperative delirium compared to ACDF (24.3% vs 7.1%, OR 4.18) in older patients with degenerative cervical myelopathy.
Why the study?
Postoperative delirium is a common surgical complication affecting recovery and outcomes, motivating an analysis of its incidence and risk factors in degenerative cervical myelopathy.
Does laminoplasty compared to ACDF affect the incidence of postoperative delirium in patients aged 60 or older with Degenerative Cervical Myelopathy?
Cohort (n=148)
No
Does laminoplasty compared to ACDF affect the incidence of postoperative delirium in patients aged 60 or older with Degenerative Cervical Myelopathy?
Laminoplasty is associated with a significantly higher incidence of postoperative delirium compared to ACDF in older patients with degenerative cervical myelopathy.
Answers are grounded in this paper and cite their sources.
POD incidence in DCM surgery merits preoperative screening in older adults; leaves open targeted prevention strategies pending prospective validation.
Delirium is one of the most common postoperative complications in surgical procedures. Postoperative delirium (POD) may affect normal recovery and outcomes after surgery. Degenerative Cervical myelopathy (DCM), a disease that progresses with age, usually associated with neurological symptoms. This study is designed to analyze the incidence and risk factors that cause post-operative delirium in DCM. The incidence and risk factors of delirium were analyzed in 148 patients aged 60 years or older who underwent surgery for DCM. Among the 148 patients who underwent surgery, 78 received laminoplasty, of whom 19 patients (24%) experienced delirium; the other 70 patients underwent ACDF, of whom five patients (7.1%) experienced delirium. The occurrence of POD in the laminoplasty group was 4.18 times higher than that in the ACDF group. Age, and sodium level were found to be significant risk factors for all 148 patients in a multivariate analysis. In the laminoplasty group, age, and high potassium level were meaningful risk factors in multiple regression analysis. Risk factors that affect the POD were not analyzed in ACDF due to the low n(=5). This study shows that the incidence and risk factors for POD can vary depending on the surgical method employed in patients with DCM.
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Kim et al. (2020) conducted a cohort in Degenerative Cervical Myelopathy (n=148). Laminoplasty vs. Anterior Cervical Discectomy and Fusion (ACDF) was evaluated on Incidence of postoperative delirium (OR 4.18, 95% CI 1.47-11.9, p=0.050). Laminoplasty was associated with a significantly higher incidence of postoperative delirium compared to ACDF (24.3% vs 7.1%, OR 4.18) in older patients with degenerative cervical myelopathy.
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