| Clinical and Radiographic Outcomes after Cervical Laminoplasty of Elderly Patients: Is There Difference from Nonelderly Patients ? |
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Jin Seop Hwang , Jung Hwan Lee , Sang Hyo Kim , Won Il Joo , Chung Kee Chough |
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Department of Neurosurgery, Catholic Neuroscience Center, St. Mary’s Hospital, The Catholic University of Korea |
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| Abstract |
Objective
The purpose of this study was to compare the surgical outcomes between nonelderly and elderly patients who underwent cervical
laminoplasty.
Methods
A total of 37 consecutive patients with cervical spondylotic myelopathy (CSM) (27 men; 10 women) who underwent cervical laminoplasty
were included. Average postoperative follow-up period was 26 months (range, 12-88). Mean age was 63 years (range, 28-80). Patients
were divided into two groups by age: nonelderly (<65 years) and elderly (≥65 years). The number of patients in each group was 18 and
19. We collected perioperative and follow-up data, including clinical and radiographic results. The Japanese Orthopaedic Association (JOA)
scoring system, neck disability index (NDI) and visual analog scale (VAS) were used analyzing clinical outcomes. Cervical alignments and flexionextension
range of motion (ROM) were measured by the Cobb method at C2-C7.
Results
Mean preopervative VAS neck pain scores (p=0.001), NDI scores (p=0.01) and JOA scores (p=0.048) in the nonelderly group were
higher than the elderly group. However, there were no significant differences in theses scores after surgery (p>0.05). The mean cervical alignments
were decreased by 3.1±7.9° in lordosis, but this decreases were not statistically significant between the nonelderly and elderly group (p=0.171).
The mean ROMs were decreased by 13.6±10.5° in the last follow-up. In the nonelderly group, ROM changes were higher than elderly (19.09±12.35°
vs. 8.45±4.51°; p=0.002). Postoperative VAS neck pain score and NDI did not correlate with cervical alignment and ROM changes.
Conclusion
Preoperative JOA scores were low in elderly patients. However, postoperative JOA scores were similar. Radiographically, neck
motions were more preserved in elderly patients than nonelderly patients, but that was not associated with the postoperative neck pain. Thus,
elderly patients could obtain reasonable recovery after laminoplasty. |
| Key Words:
AgedㆍCervical vertebraeㆍSpinal cord compressionㆍTreatment outcome |
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