高齢者頸椎症に対する頸椎前方手術の臨床的検討

抄録

  The purpose of this study was to evaluate the effect of age on outcome of anterior spinal surgery in elderly patients with cervical spondylosis.

  We reviewed the cases of 14 non-elderly (<65 years of age), 9 early elderly (65-74 years of age), and 11 late elderly (>75 years of age) patients in whom anterior cervical decompression and fusion were performed for cervical spondylosis myelopathy. Effect of age on surgical outcome was statistically analyzed by evaluating the JOA score, Barthel index, and their recovery rates.

  Preoperative JOA scores and Barthel index declined with age. Postoperatively, JOA scores and Barthel index rose in all three age groups but only the increase in JOA score in the non-elderly group was statistically significant. Recovery rates of JOA scores were poor in both the early and late elderly patient groups.

  Although an age effect on outcome for anterior spinal surgery in elderly patients is evident, there is still the possibility of neurological recovery and improvement in activity of daily life in elderly patients. We need a special management to avoid postoperative confusion in late elderly patients.