Laminoplasty for patients aged 75 years or older with cervical myelopathy.
OBJECTIVE
To assess the neurological and walking status of 56 elderly patients after cervical myelopathy to determine whether the surgery was justified.


METHODS
Records of 23 men and 33 women aged 75 to 86 (mean, 79) years who underwent laminoplasty for cervical myelopathy were retrospectively reviewed. They had been followed up for a mean of 3.5 (range, 0.2-8.6) years. Walking status was assessed according to long-term care insurance criteria. In 45 patients with more than 2 years of follow-up, neurological status was evaluated according to the Japanese Orthopaedic Association (JOA) score. Neurological recovery rate was classified as excellent, good, fair, poor, and worse.


RESULTS
Postoperatively, of the 47 patients still living, 22 could walk independently, 22 required assistance outdoors, 2 were using a wheelchair, and one was bedridden. The mean JOA score was 9.7 preoperatively, 12.2 one year postoperatively, and 11.8 at final assessment (p<0.001). The mean neurological recovery rate was 29% at one-year follow-up and 24% at final assessment (p=0.06).


CONCLUSIONS
Although excellent results were not expected in elderly patients, surgery to maintain independent walking status was justified in most of our patients.
Ishii
M
M
Department of Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, Osaka, Japan. masa-ishii@umin.ac.jp
Wada
E
E
Ishii
T
T
Kawai
H
H
Kaneko
N
N
Fuji
T
T
D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome