Document Detail


Surgical outcomes of elderly patients with cervical spondylotic myelopathy.
MedLine Citation:
PMID:  18325426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cervical spondylotic myelopathy is a potentially serious neurologic disorder that commonly presents with gait difficulty and hand dysfunction. Because the development of CSM is in large part related to advanced spondylosis and degenerative disk disease, elderly patients appear to be at an increased risk to develop this condition. The surgical outcomes of this patient population have been understudied; the authors seek to report their clinical results in a series of patients with CSM older than 75 years who underwent surgical treatment. METHODS: This report is composed of a cohort of 36 elderly patients (older than 75 years) and 34 younger patients (younger than 65 years) who underwent decompressive surgery for CSM at one institution between 2001 and 2005. The patients' functional status was evaluated preoperatively and postoperatively using the mJOA disability scale. RESULTS: The mean follow-up time in the elderly group was 24 months, with a range from 12 to 48 months. There was a statistically significant improvement between mean preoperative (11.3) and postoperative (14.4) mJOA scores (P< .0001). The younger group had a higher neurologic recovery rate (71%) than the elderly group (59%); however, this was not statistically significant (P= .29). The postoperative complication rate in the elderly population (38%) was higher than in the younger group (6%; P= .002). CONCLUSION: Elderly patients with CSM are likely to obtain neurologic improvement after decompressive surgery. Their postoperative complication rate is higher than that of younger patients, yet most complications appear to be self limiting and do not adversely affect neurologic outcome.
Authors:
Langston T Holly; Parham Moftakhar; Larry T Khoo; A Nick Shamie; Jeffrey C Wang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  69     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-07     Completed Date:  2008-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  233-40     Citation Subset:  IM    
Affiliation:
Division of Neurosurgery, David Geffen UCLA School of Medicine, Los Angeles, CA 90095, USA. lholly@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cervical Vertebrae / pathology*,  surgery*
Decompression, Surgical / methods*
Female
Humans
Laminectomy / methods*
Magnetic Resonance Imaging
Male
Middle Aged
Movement Disorders / epidemiology
Muscle Weakness / epidemiology,  physiopathology
Neurosurgical Procedures / methods*
Psychomotor Disorders / epidemiology
Recovery of Function*
Reflex, Abnormal / physiology
Spinal Cord Compression / epidemiology,  pathology,  surgery
Spinal Cord Diseases / epidemiology*,  surgery*
Spinal Osteophytosis* / epidemiology,  pathology,  surgery
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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