J Korean Soc Spine Surg.  2001 Mar;8(1):68-73.

Outcome Analysis of Cervical Myelopathy in Patients More Than 70 Years of Age

• Song KW
• Park IH
• Shin SI
• Lee JY
• Moon HD

Abstract

STUDY DESIGN: A retrospective study.
OBJECTIVES
To evaluate the surgical outcomes and image by mid-sagittal MRI in patients with cervical myelopathy who were more than 70 years of age. SUMMARY OF LITERATURE REVIEW: Surgical outcomes of cervical myelopathy in the elderly patients were worse than in the younger patients, but decompression surgery is helpful for improving neurologic function in the elderly.
MATERIALS AND METHODS
Nine patients more than 70 years of age who underwent surgery were reviewed. Neurologic deficits after surgery were assessed using a scoring system proposed by Japanese Orthopaedic Association( JOA ) and clinical results and morphological changes on MRI were compared with those of patients less than 70 years old age.
RESULTS
The preoperative mean JOA score was 8.5 and the postoperative mean JOA score 12.8 and the maximum recovery rate was 51.1%, but these were significantly inferior to scores in those less than 70 years of age. At the time of final follow up , the mean JOA score had decreased 11.3 and the recovery rate was 32.6%. All patients except one were improved their daily living function. On the postoperative midline T1 sagittal MRI, morphological improvement was seen in 44% in patients more than 70 years of age, while 69% of patients were improved in the control group.
CONCLUSIONS
Surgical decompression appears to be necessary as soon as possible after the onset of progressive myelopathy in the elderly patients for improving neurologic function and ability to engage in daily living.

Keyword

Cervical spine; Myelopathy; Aged; Decompression surgery

MeSH Terms

Aged
Asian Continental Ancestry Group
Decompression
Decompression, Surgical
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Neurologic Manifestations
Retrospective Studies
Spinal Cord Diseases*

Figure

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  Fig. 1. Classification of compressed deformities in the cervical cord on the sagittal MRI.

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  Fig. 2. Change in the JOA score.

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  Fig. 3. 72-year-old woman. A. preoperative lateral radiograph. B. postoperative lateral radiograph.

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  Fig. 4. 72-year-old woman. A, B. preoperative sagittal MRI. C, D. postoperative sagittal MRI

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  Fig. 5. 71-year-old man. A. preoperative lateral radiograph. B. postoperative lateral radiograph.

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  Fig. 6. 71-year-old man. A. preoperative sagittal T2-weighted MRI showed high signal area. C. postoperative sagittal T2-weighted MRI showed no signal change.

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  Fig. 7. 73-year-old man. A. preoperative sagittal MRI. B. post-operative sagittal MRI.

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