title: Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients aged 80 years or older: a multi-center retrospective study.
abstract: With the aging of the population in developed countries, spine surgeons have recently been more likely to encounter elderly patients in need of treatment. This study investigated whether decompression surgery for cervical spondylotic myelopathy (CSM) in elderly patients aged 80 years or older would likely be a reasonable treatment. We retrospectively reviewed 605 consecutive patients with cervical myelopathy who underwent decompression surgery between 2004 and 2008. Patients with other conditions that could affect functional status or compression factors other than spondylosis were excluded from this study. Of the remaining 189 patients, 161 with CSM whose condition could be evaluated 6 months after surgery were analyzed. The patients were divided into two age groups: 80 years or older (Group A, 37 patients) and younger than 80 years of age (Group B, 124 patients). We evaluated the differences in symptom duration, clinical data, involved levels, surgical outcome, comorbidities, and postoperative complications between the two groups. The symptom duration was significantly shorter in Group A. The average JOA scores preoperatively and 6 months postoperatively were significantly lower in Group A; however, there was no significant difference in the recovery ratio. There were no significant differences in the percentages of patients with comorbidities or those with postoperative complications. Elderly patients aged 80 years or older regained approximately 40% of their function postoperatively, and the incidence of postoperative complication was similar to that in younger patients. Since this age group shows a rapid deterioration after onset, prompt decompression surgery is required.
authors.affiliation: Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, 683-8504, Japan. hidekin@med.tottori-u.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Nagashima
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Dokai
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Hashiguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishii
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kameyama
authors.forename: Yuji
authors.initials: Y
authors.lastname: Katae
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morio
authors.forename: Tsugutake
authors.initials: T
authors.lastname: Morishita
authors.forename: Masaaki
authors.initials: M
authors.lastname: Murata
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Nanjo
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanida
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanishima
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 / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000473:pathology / Q000601:surgery*; D055009:Spondylosis / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome