Clinical results of anterior decompression surgery for cervical myelopathy in aged patients
- VernacularTitle:高龄颈椎病患者前路减压手术的疗效
- Author:
Jun LU
;
Xiaotao WU
;
Zubin MAO
- Publication Type:Journal Article
- Keywords:
Cervical spondylosis;
Aged;
Decompression, surgical
- From:
Chinese Journal of Orthopaedics
2000;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinical features and anterior surgical results of cervical myelopathy in patients more than 70 years of age. Methods Twenty aged patients with cervical myelopathy who underwent anterior decompression with bone graft surgery were reviewed. Neurological function was assessed using a scoring system proposed by the Japanese Orthopaedic Association (JOA score). The clinical results and complications were compared with the control group which included 31 patients with multisegmental cervical myelopathy and less than 69 years old and underwent the same operation. Results The preoperative mean JOA score was 9.3 (ranged from 3 to 14) and the JOA score at latest follow-up averaged 13.4 (ranged from 8 to 17) in the aged patient group. 68 percent patients had achieved an excellent or good result and the recovery rate was 58%. 71 percent patients had achieved an excellent or good result and the recovery rate was 67% in the control group. No statistical difference was found in the excellent and good result rate or the recovery rate of JOA score between the aged group and the control group (?字2=0.04, P=0.85;t=1.12, P=0.138). The incidence of surgical related complications in the aged group was 35% (7 cases), which was considerably higher than that in the control group (3 cases, 10%) but without statistical difference (?字2=3.47, P=0.06). In the preoperative flexion-extension stress lateral radiographs, the incidence of cervical instability was higher in the control group (8 cases, 26%) than that in the aged group(1 case, 5%). Conclusion 1) Multilevel lesion induced by overcompensation for cervical instability are the probable cause of myelopathy in aged patients. 2) Anterior decompression is beneficial to improve the neurological function and life style in the aged patients with cervical myelopathy, but associated with a high incidence of surgical complications.
