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
N1 - Publisher Copyright:
Copyright © 2018 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
PY - 2018
Y1 - 2018
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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U2 - 10.1097/BRS.0000000000002751
DO - 10.1097/BRS.0000000000002751
M3 - Article
C2 - 29916956
AN - SCOPUS:85061283457
SN - 0362-2436
VL - 43
SP - E1430-E1436
JO - Spine
JF - Spine
IS - 24
ER -