Postoperative morbidity and mortality in patients with vertigo undergoing elective laminectomy

Authors

  • Basir S. Mansoor University of Texas Southwestern Medical Center, Dallas, TX, USA
  • Zuhair Zaidi University of Texas Southwestern Medical Center, Dallas, TX, USA
  • Syed Murtaza Kazmi University of Texas Southwestern Medical Center, Dallas, TX, USA
  • Muaz Wahid University of Texas Southwestern Medical Center, Dallas, TX, USA
  • Ahmed Sajjad University of Texas at Dallas, Richardson, TX, USA
  • Naasik Syed University of Texas Southwestern Medical Center, Dallas, TX, USA
  • Rance J. T. Fujiwara Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
  • Salah G. Aoun Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261838

Keywords:

Vertigo, Elective laminectomy, Propensity score matching, Falls, Stroke, Spine surgery

Abstract

Background: Vertigo is frequently encountered in patients undergoing elective spine surgery, yet its association with postoperative morbidity and mortality after laminectomy remains poorly defined. We evaluated short- and long-term postoperative outcomes among patients with preoperative vertigo undergoing elective laminectomy after rigorous adjustment for comorbid disease burden.

Methods: We performed a retrospective propensity score-matched cohort study comparing adults undergoing elective laminectomy with preoperative peripheral vertigo to those without. Vertigo was identified using ICD-10 codes (H81.x), excluding central neurologic, cerebrovascular, autonomic, traumatic, and infectious etiologies. Cohorts were matched 1:1 (6,031 per group) on demographics, comorbidities, laboratory values, and medication exposures. Outcomes were assessed at 90 days and 1 year with falls serving as the primary outcome. To account for multiple secondary outcome comparisons, a Bonferroni correction was applied, with statistical significance set at p<0.002.

Results: Postoperative falls was significantly elevated at 90 days (OR=1.97) and 1 year (OR=1.75). Among secondary outcomes, the vertigo cohort demonstrated significantly higher rates of stroke (OR=2.31 at 90 days; OR=2.33 at 1 year), nausea or vomiting (OR=1.86; OR=1.98), fall-related fractures (OR=1.70 at 90 days), somnolence or stupor (OR=2.44; OR=2.21), myocardial infarction (OR=1.85 at 1 year), urinary tract infection (OR=1.57 at 1 year), amnesia (OR=2.36 at 1 year), and emergency department utilization (OR=1.45 at 1 year). Trends toward elevated venous thromboembolism, myocardial infarction at 90 days, and all-cause mortality at 1 year (OR=1.52; p=0.0037) were observed.

Conclusions: Preoperative peripheral vertigo is associated with increased postoperative morbidity across neurologic, cardiovascular, functional, and healthcare utilization domains following elective laminectomy, with a trend toward elevated 1-year mortality. These findings suggest vertigo may represent a clinically meaningful risk modifier and support prospective evaluation of enhanced preoperative optimization and fall-prevention protocols in this population.

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Published

2026-06-05

How to Cite

Mansoor, B. S., Zaidi, Z., Kazmi, S. M., Wahid, M., Sajjad, A., Syed, N., Fujiwara, R. J. T., & Aoun, S. G. (2026). Postoperative morbidity and mortality in patients with vertigo undergoing elective laminectomy. International Journal of Research in Orthopaedics. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261838

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