Abstract
Nineteen patients aged 80 and older (super-old group) underwent either an anterior microsurgical decompression and fusion (15) or laminoplasty (4) for cervical spondylotic myelopathy (CSM) during a 10 year period from September 1993 to April 2003. Of the 15 patients treated by anterior surgery, 12 had a single-level operation at level C3-4 or C4-5 based on the spinal cord evoked potential and MRI, and 3 patients had two-level operation. Although functional improvement was neutralized by other age-related condition, impairing ability to walk, such as osteoarthritis of the knee (7 patients), the hip (1 patient), or lumbar stenosis (2 patients), the average Japanese Orthopaedic Association (JOA) score significantly improved from 6.1 before operation to 10.6 at a mean follow-up of 22 months. A high incidence (42%) of delirium characterized postoperative transient complication in this age group. The improvement rate of JOA score in the super-old group was not significantly different (43% vs 52%) from that of a younger group of patients aged between 60 and 80 who had an operation for CSM in the same period of time. Despite frequent comorbidities impaired general health in CSM patients 80-years-old and over, functional recovery after surgical intervention was similar to the younger group.
