Outcomes of surgical treatment for cervical myelopathy in patients more than 75 years of age

Study-Design. Retrospective study on the results of surgical treatment of c ompressive cervical myelopathy in patients more than 75 years of age. Objectives. To investigate clinical features and surgical outcomes of compr essive cervical myelopathy in aged patients and to discuss the role of surg ical treatment. Summary of Background Data. There are few data focused on the outcomes of s urgery in patients with cervical myelopathy who are more than 75 years of a ge. Methods. Seventeen patients with compressive cervical myelopathy who underw ent surgery were reviewed. The average age at the time of surgery was 77.2 years. Posterior decompression in 15 patients and anterior decompression in 2 patients were performed. Neurologic deficits before and after surgery we re assessed using a scoring proposed by the Japanese Orthopaedic Associatio n (JOA score). Independence of daily living was evaluated. Radiologic featu res were examined with radiographs and magnetic resonance imaging. Clinical results were compared with those of patients less than 65 years old as a c ontrol. Results, The preoperative mean JOA score was 6.1, the postoperative maximum JOA scores averaged 11.4, and the recovery rate was 48.4%. These were sign ificantly inferior to scores in those less than 65 years of age. All seven of the patients who could not walk even with aids before surgery became ind ependent in daily activities afters surgery, At the final follow-up, the me an JOA score had decreased to 10.7 and the recovery rate to 39.1%. Five, of nine patients whose follow-up periods were more than 5 years showed decrea ses in JOA score, although all patients were still ambulatory. Conclusions. Surgical decompression for cervical myelopathy appears to be b eneficial, even in patients more than 75 years of age, in improving neurolo gic function and ability to engage in activities of daily living.