Clinical study of cognitive dysfunction after scoliosis orthopedics in adolescent

Abstract

Objective To observe the incidence of postoperative cognitive dysfunction (POCD) in adolescent scoliosis patients.Methods Fifty-two patients with ASA grade Ⅰ or Ⅱ,aged from 11 to 18 years,undergoing elective posterior scoliosis orthopedic surgery were enrolled.Patients were assigned into POCD group or NONPOCD group according to their performances of neuropsychological tests.The tests were as follows:mini mental state examination (MMSE),visual verbal learning test,stroop color word test,digit span test,trail making test and digit symbol test.Cognitive function was assessed respectively on one day before surgery and the seventh day after surgery.Age,gender,years of education,past medical history,visual analog scale (VAS) on the first and third day after surgery and postoperative complications were recorded.Then the data was statistically analysed.Results One patient was excluded because his preoperative MMSE score was 21,other Fifty-one patients finished the tests.According to the diagnostic criteria,fifteen patients developed POCD (29.4％).After calculation,it is found that many patients showed decline in the performance of visual verbal learning test (29.4％) and stroop color naming test (23.5％).In addition,more than fifty percent of the patients in POCD group also showed decline in these two tests.Statistical analysis showed that there was no significant difference between POCD and NONPOCD group on intraoperative fluid intake and loss,length of stay in postanesthesia care unit(PACU),extubation time or duration of surgery (P＞0.05).The VAS score of all patient at 1 d before surgery was 0; and at 1,3 d after surgery,this score was (4±2) and (2± 1),respectively,which there exist statistically significant within-group difference (P＜0.05),but no difference between the two groups.Conclusions The incidence of POCD is 29.4％ on the seventh day after scoliosis orthopedic surgery,to which full attention must be paid. Key words: Scoliosis orthopedic surgery ; Postoperative cognitive dysfunction ; Clinical study ;