title: Intraoperative electroneurography in the assessment of the level of operation for cervical spondylotic myelopathy in the elderly.
abstract: We treated 31 patients aged 65 years or more with cervical spondylotic myelopathy by microsurgical decompression and fusion at a single most appropriate level, in spite of MRI evidence of compression at several levels. Spinal cord potentials evoked at operation localised the level responsible for the principal lesion at C3-4 in 18 patients, C4-5 in 11 and at C5-6 in two. Despite the frequent coexistence of other age-related conditions, impairing ability to walk, the average Nurick grade improved from 3.5 before operation to 2.2 at a mean follow-up of 48 months. There was also good recovery of finger dexterity and sensitivity. Operation at a single optimal level, as opposed to several, has the advantage of minimising complications, of particular importance in this age group.
authors.affiliation: Department of Orthopaedic Surgery, Kochi Medical School, Nankoku City, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tani
authors.forename: K
authors.initials: K
authors.lastname: Ishida
authors.forename: T
authors.initials: T
authors.lastname: Ushida
authors.forename: H
authors.initials: H
authors.lastname: Yamamato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical; D004568:Electrodiagnosis; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D013116:Spinal Cord / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion; D013167:Spondylitis, Ankylosing / Q000503:physiopathology / Q000601:surgery*