Surgical treatment of cervical spondylotic myelopathy in the elderly

Norihiro Isogai, Narihito Nagoshi, Akio Iwanami, Hitoshi Kono, Yoshiomi Kobayashi, Takashi Tsuji, Nobuyuki Fujita, Mitsuru Yagi, Kota Watanabe, Kazuya Kitamura, Yuta Shiono, Masaya Nakamura, Morio Matsumoto, Ken Ishii, Junichi Yamane

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Study Design. Retrospective multicenter study. Objective. We aimed to assess the outcomes following posterior cervical decompression for cervical spondylotic myelopathy (CSM) in a large sample of patients older than 80 years. Summary of Background Data. Although age is a predictor of surgical outcomes for CSM, most previous studies have only investigated the effect of age for patients aged 65 to 75 years, and surgical outcomes remain unclear for older patients. Methods. Patients older than 50 years who underwent posterior cervical decompression for CSM were enrolled from 17 institutions. The patients were grouped into a youngold group (>80 yrs old) and an oldold group (-80 yrs). Clinical information, comorbidities, perioperative complications, Japanese Orthopaedic Association (JOA) scores, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), visual analog scale (VAS) scores, and radiographic parameters were compared between the two groups. All patients were followed for at least 1 year after surgery. Results. The youngold and oldold groups included 491 and 77 patients, respectively. The JOA score and quality of life measured by JOACMEQ improved significantly after surgery in both groups. Compared with the youngold group, the oldold group had lower preoperative JOA scores (9.6 vs. 11.0), lower final JOA scores (12.6 vs. 14.0), and lower recovery rates (42% vs. 50%). However, there were no significant differences in perioperative complications or in the VAS scores at the final assessments. The oldold group had a higher mean preoperative sagittal Cobb angle at C2C5, though this was not statistically significant postoperatively. Conclusion. Posterior decompression surgery is safe and beneficial for patients older than 80 years with CSM, despite having a more limited neurological recovery compared with younger patients.

Original languageEnglish
Pages (from-to)E1430-E1436
JournalSpine
Volume43
Issue number24
DOIs
Publication statusPublished - 01-01-2018

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Spinal Cord Diseases
Orthopedics
Decompression
Therapeutics
Visual Analog Scale
Multicenter Studies
Comorbidity
Retrospective Studies
Quality of Life

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Isogai, N., Nagoshi, N., Iwanami, A., Kono, H., Kobayashi, Y., Tsuji, T., ... Yamane, J. (2018). Surgical treatment of cervical spondylotic myelopathy in the elderly. Spine, 43(24), E1430-E1436. https://doi.org/10.1097/BRS.0000000000002751
Isogai, Norihiro ; Nagoshi, Narihito ; Iwanami, Akio ; Kono, Hitoshi ; Kobayashi, Yoshiomi ; Tsuji, Takashi ; Fujita, Nobuyuki ; Yagi, Mitsuru ; Watanabe, Kota ; Kitamura, Kazuya ; Shiono, Yuta ; Nakamura, Masaya ; Matsumoto, Morio ; Ishii, Ken ; Yamane, Junichi. / Surgical treatment of cervical spondylotic myelopathy in the elderly. In: Spine. 2018 ; Vol. 43, No. 24. pp. E1430-E1436.
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abstract = "Study Design. Retrospective multicenter study. Objective. We aimed to assess the outcomes following posterior cervical decompression for cervical spondylotic myelopathy (CSM) in a large sample of patients older than 80 years. Summary of Background Data. Although age is a predictor of surgical outcomes for CSM, most previous studies have only investigated the effect of age for patients aged 65 to 75 years, and surgical outcomes remain unclear for older patients. Methods. Patients older than 50 years who underwent posterior cervical decompression for CSM were enrolled from 17 institutions. The patients were grouped into a youngold group (>80 yrs old) and an oldold group (-80 yrs). Clinical information, comorbidities, perioperative complications, Japanese Orthopaedic Association (JOA) scores, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), visual analog scale (VAS) scores, and radiographic parameters were compared between the two groups. All patients were followed for at least 1 year after surgery. Results. The youngold and oldold groups included 491 and 77 patients, respectively. The JOA score and quality of life measured by JOACMEQ improved significantly after surgery in both groups. Compared with the youngold group, the oldold group had lower preoperative JOA scores (9.6 vs. 11.0), lower final JOA scores (12.6 vs. 14.0), and lower recovery rates (42{\%} vs. 50{\%}). However, there were no significant differences in perioperative complications or in the VAS scores at the final assessments. The oldold group had a higher mean preoperative sagittal Cobb angle at C2C5, though this was not statistically significant postoperatively. Conclusion. Posterior decompression surgery is safe and beneficial for patients older than 80 years with CSM, despite having a more limited neurological recovery compared with younger patients.",
author = "Norihiro Isogai and Narihito Nagoshi and Akio Iwanami and Hitoshi Kono and Yoshiomi Kobayashi and Takashi Tsuji and Nobuyuki Fujita and Mitsuru Yagi and Kota Watanabe and Kazuya Kitamura and Yuta Shiono and Masaya Nakamura and Morio Matsumoto and Ken Ishii and Junichi Yamane",
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Isogai, N, Nagoshi, N, Iwanami, A, Kono, H, Kobayashi, Y, Tsuji, T, Fujita, N, Yagi, M, Watanabe, K, Kitamura, K, Shiono, Y, Nakamura, M, Matsumoto, M, Ishii, K & Yamane, J 2018, 'Surgical treatment of cervical spondylotic myelopathy in the elderly', Spine, vol. 43, no. 24, pp. E1430-E1436. https://doi.org/10.1097/BRS.0000000000002751

Surgical treatment of cervical spondylotic myelopathy in the elderly. / Isogai, Norihiro; Nagoshi, Narihito; Iwanami, Akio; Kono, Hitoshi; Kobayashi, Yoshiomi; Tsuji, Takashi; Fujita, Nobuyuki; Yagi, Mitsuru; Watanabe, Kota; Kitamura, Kazuya; Shiono, Yuta; Nakamura, Masaya; Matsumoto, Morio; Ishii, Ken; Yamane, Junichi.

In: Spine, Vol. 43, No. 24, 01.01.2018, p. E1430-E1436.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Surgical treatment of cervical spondylotic myelopathy in the elderly

AU - Isogai, Norihiro

AU - Nagoshi, Narihito

AU - Iwanami, Akio

AU - Kono, Hitoshi

AU - Kobayashi, Yoshiomi

AU - Tsuji, Takashi

AU - Fujita, Nobuyuki

AU - Yagi, Mitsuru

AU - Watanabe, Kota

AU - Kitamura, Kazuya

AU - Shiono, Yuta

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Ishii, Ken

AU - Yamane, Junichi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Study Design. Retrospective multicenter study. Objective. We aimed to assess the outcomes following posterior cervical decompression for cervical spondylotic myelopathy (CSM) in a large sample of patients older than 80 years. Summary of Background Data. Although age is a predictor of surgical outcomes for CSM, most previous studies have only investigated the effect of age for patients aged 65 to 75 years, and surgical outcomes remain unclear for older patients. Methods. Patients older than 50 years who underwent posterior cervical decompression for CSM were enrolled from 17 institutions. The patients were grouped into a youngold group (>80 yrs old) and an oldold group (-80 yrs). Clinical information, comorbidities, perioperative complications, Japanese Orthopaedic Association (JOA) scores, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), visual analog scale (VAS) scores, and radiographic parameters were compared between the two groups. All patients were followed for at least 1 year after surgery. Results. The youngold and oldold groups included 491 and 77 patients, respectively. The JOA score and quality of life measured by JOACMEQ improved significantly after surgery in both groups. Compared with the youngold group, the oldold group had lower preoperative JOA scores (9.6 vs. 11.0), lower final JOA scores (12.6 vs. 14.0), and lower recovery rates (42% vs. 50%). However, there were no significant differences in perioperative complications or in the VAS scores at the final assessments. The oldold group had a higher mean preoperative sagittal Cobb angle at C2C5, though this was not statistically significant postoperatively. Conclusion. Posterior decompression surgery is safe and beneficial for patients older than 80 years with CSM, despite having a more limited neurological recovery compared with younger patients.

AB - Study Design. Retrospective multicenter study. Objective. We aimed to assess the outcomes following posterior cervical decompression for cervical spondylotic myelopathy (CSM) in a large sample of patients older than 80 years. Summary of Background Data. Although age is a predictor of surgical outcomes for CSM, most previous studies have only investigated the effect of age for patients aged 65 to 75 years, and surgical outcomes remain unclear for older patients. Methods. Patients older than 50 years who underwent posterior cervical decompression for CSM were enrolled from 17 institutions. The patients were grouped into a youngold group (>80 yrs old) and an oldold group (-80 yrs). Clinical information, comorbidities, perioperative complications, Japanese Orthopaedic Association (JOA) scores, Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), visual analog scale (VAS) scores, and radiographic parameters were compared between the two groups. All patients were followed for at least 1 year after surgery. Results. The youngold and oldold groups included 491 and 77 patients, respectively. The JOA score and quality of life measured by JOACMEQ improved significantly after surgery in both groups. Compared with the youngold group, the oldold group had lower preoperative JOA scores (9.6 vs. 11.0), lower final JOA scores (12.6 vs. 14.0), and lower recovery rates (42% vs. 50%). However, there were no significant differences in perioperative complications or in the VAS scores at the final assessments. The oldold group had a higher mean preoperative sagittal Cobb angle at C2C5, though this was not statistically significant postoperatively. Conclusion. Posterior decompression surgery is safe and beneficial for patients older than 80 years with CSM, despite having a more limited neurological recovery compared with younger patients.

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Isogai N, Nagoshi N, Iwanami A, Kono H, Kobayashi Y, Tsuji T et al. Surgical treatment of cervical spondylotic myelopathy in the elderly. Spine. 2018 Jan 1;43(24):E1430-E1436. https://doi.org/10.1097/BRS.0000000000002751