Journal of Korean Society of Geriatric Neurosurgery 2014;10(2):162-168.
Published online December 30, 2014.
The Effect of Anterior Cervical Discectomy and Fusion on the Improvement of Gait in Elderly Patients with Nurick Grade 5 by Cervical Spondylotic Myelopathy
Dae Young Jung , Keun-Tae Cho
Department of Neurosurgery, Dongguk University Ilsan Hospital, Goyang, and Dongguk University, Seoul, Korea
Nurick Grade 5 퇴행성 경추 척수병증 노인 환자에서 전방 경추 추간판 절제와 골유합술 후 보행 회복에 관한 연구
정대영·조근태
동국대학교 일산병원 신경외과학교실
Abstract
Objective
The objective of the study is to evaluate the effect of anterior cervical discectomy and fusion (ACDF) on the improvement of gait in elderly patients with Nurick grade 5 by cervical spondylotic myelopathy (CSM), and discuss the clinical and radiological predictors of outcome.
Methods
We retrospectively analyzed patients with Nurick grade 5 (bedridden or chair bound) by CSM who received an ACDF between 2005 and 2013. Data were collected on patient clinical characteristics and number of levels of cord compression, high signal intensity, and cord compromise ratio in the preoperative MR imaging were investigated. The patients were followed up for at least 6 months after the surgery and Nurick grade at last follow-up was evaluated.
Results
Nine patients were identified and mean age was 74.44±6.41 years. Eight patients were followed up for at least 6 months. Statistically significant improvement on Nurick grade was found and the mean postoperative Nurick grade was 3.75±1.28 (p=0.041). Five of 8 patients improved at least one degree on the Nurick grade at last follow-up. Three of 8 were able to walk independently at last follow-up. No statistically significant prognostic factors for the improvement on Nurick grade and regaining the ability to walk independently were found.
Conclusion
About 60% of elderly patients with Nurick grade 5 by CSM improved at least one degree on Nurick grade after ACDF, and about 40% of patients regained the ability to walk independently. In elderly patients with Nurick grade 5 by CSM, ACDF could be positively considered as a treatment option.
Key Words: Cervical spondylosisㆍMyelopathyㆍNurick grade


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