Laminoplasty for patients aged 75 years or older with cervical myelopathy

Journal of Orthopaedic Surgery
M IshiiT Fuji

Abstract

To assess the neurological and walking status of 56 elderly patients after cervical myelopathy to determine whether the surgery was justified. Records of 23 men and 33 women aged 75 to 86 (mean, 79) years who underwent laminoplasty for cervical myelopathy were retrospectively reviewed. They had been followed up for a mean of 3.5 (range, 0.2-8.6) years. Walking status was assessed according to long-term care insurance criteria. In 45 patients with more than 2 years of follow-up, neurological status was evaluated according to the Japanese Orthopaedic Association (JOA) score. Neurological recovery rate was classified as excellent, good, fair, poor, and worse. Postoperatively, of the 47 patients still living, 22 could walk independently, 22 required assistance outdoors, 2 were using a wheelchair, and one was bedridden. The mean JOA score was 9.7 preoperatively, 12.2 one year postoperatively, and 11.8 at final assessment (p<0.001). The mean neurological recovery rate was 29% at one-year follow-up and 24% at final assessment (p=0.06). Although excellent results were not expected in elderly patients, surgery to maintain independent walking status was justified in most of our patients.

References

Jun 5, 2003·Clinical Orthopaedics and Related Research·Yoshiharu KawaguchiTomoatsu Kimura
Feb 1, 2006·Clinical Orthopaedics and Related Research·Hideki NagashimaRyota Teshima
Jul 5, 2006·The Journal of Bone and Joint Surgery. American Volume·Raj D RaoKenny S David

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Citations

Jan 8, 2009·Journal of Orthopaedic Surgery·O BerberQ Bismil
Jan 21, 2012·Journal of Spinal Disorders & Techniques·Masayoshi IshiiMasayuki Hamada
Apr 7, 2015·Global Spine Journal·Takafumi MaenoMotoki Iwasaki
Nov 20, 2015·BioMed Research International·Yasushi OshimaSakae Tanaka

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