title: Clinical features and surgical outcomes of cervical myelopathy in the elderly.
abstract: Treatment of cervical myelopathy in elderly patients is controversial. We retrospectively studied 113 patients who had decompression surgery from 1990-2001 to clarify how pre-operative conditions, duration of symptoms, involved levels, surgical outcomes, and complications differ between younger and elderly patients. We also asked whether elderly patients would likely have reasonable outcomes of surgery. The patients were divided into five age groups: Group 1, 36-45 years (12 patients); Group 2, 46-55 years (22 patients); Group 3, 56-65 years (31 patients); Group 4, 66-75 years (32 patients); and Group 5, 76-85 years (16 patients). The duration of symptoms was similar among the five groups. The involved level was more cephalic in the older groups, and the most frequently involved level in patients older than 75 years was C3-C4. Neurologic symptoms were more severe preoperatively and postoperatively in older patients. The recovery ratio also was lower in older patients; however, in Group 5 it was 36.9%, which indicated that patients older than 75 years could regain approximately 40% of their function postoperatively. Decompression surgery can be a reasonable treatment option for cervical myelopathy, even in elderly patients.
  
  
  METHODS
  Therapeutic Study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Tottori, Japan. hidekin@grape.med.tottori-u.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Nagashima
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morio
authors.forename: Hideki
authors.initials: H
authors.lastname: Yamashita
authors.forename: Koji
authors.initials: K
authors.lastname: Yamane
authors.forename: Ryota
authors.initials: R
authors.lastname: Teshima
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae; D019299:Decompression, Surgical / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D013122:Spinal Diseases / Q000150:complications / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome