Operative Results of Canal-Expansive Laminoplasty for Cervical Spondylotic Myelopathy in Elderly Patients

Tanaka, J; Seki, Naoki; Tokimura, Fumiaki; Doi, Koichi; Inoue, Shigeru

doi:10.1097/00007632-199911150-00004

Cited by 128 publications

(64 citation statements)

References 12 publications

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“…Some studies have reported that the elderly tended to have a longer duration of symptoms, poorer surgical outcome and more cephalic levels involved [4,5,7,10]. However, other authors have not demonstrated any differences in the duration of symptoms [3,10] or surgical outcome [4,8] between elderly and younger patients. These discrepancies may be attributed to their definitions of the term elderly.…”

Section: Introductionmentioning

confidence: 99%

“…Many papers describe cervical myelopathy in elderly patients [3][4][5][6][7][8][9][10]; however, definitions of the term elderly have varied from over 65 years [7,8,10] to over 70 years [3,4,9] and to over 75 years [5,6]. Some studies have reported that the elderly tended to have a longer duration of symptoms, poorer surgical outcome and more cephalic levels involved [4,5,7,10].…”

Section: Introductionmentioning

confidence: 99%

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Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients aged 80 years or older: a multi-center retrospective study

et al. 2011

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With the aging of the population in developed countries, spine surgeons have recently been more likely to encounter elderly patients in need of treatment. This study investigated whether decompression surgery for cervical spondylotic myelopathy (CSM) in elderly patients aged 80 years or older would likely be a reasonable treatment. We retrospectively reviewed 605 consecutive patients with cervical myelopathy who underwent decompression surgery between 2004 and 2008. Patients with other conditions that could affect functional status or compression factors other than spondylosis were excluded from this study. Of the remaining 189 patients, 161 with CSM whose condition could be evaluated 6 months after surgery were analyzed. The patients were divided into two age groups: 80 years or older (Group A, 37 patients) and younger than 80 years of age (Group B, 124 patients). We evaluated the differences in symptom duration, clinical data, involved levels, surgical outcome, comorbidities, and postoperative complications between the two groups. The symptom duration was significantly shorter in Group A. The average JOA scores preoperatively and 6 months postoperatively were significantly lower in Group A; however, there was no significant difference in the recovery ratio. There were no significant differences in the percentages of patients with comorbidities or those with postoperative complications. Elderly patients aged 80 years or older regained approximately 40% of their function postoperatively, and the incidence of postoperative complication was similar to that in younger patients. Since this age group shows a rapid deterioration after onset, prompt decompression surgery is required.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients aged 80 years or older: a multi-center retrospective study

et al. 2011

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“…[9][10][11][12] The following factors have been reported to influence postoperative results: duration of the disease, severity of myelopathy, intramedullary signal intensity changes on MRI and crosssectional area of the spinal cord.…”

Section: Discussionmentioning

confidence: 99%

Outcome of late surgical treatment in patients with incomplete paraplegia due to spinal degenerative diseases

et al. 2004

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Study design: Retrospective analysis. Objective: To assess the outcome of late surgical intervention in patients with incomplete paraplegia due to spinal degenerative diseases. Setting: Three men and four women with cervical or thoracic spinal degenerative diseases, who preoperatively were unable to walk for more than 6 months in Mie prefecture, Japan. Methods: Review of clinical records and questionnaire survey regarding the walking ability of patients 2 years after surgery. Results: All seven patients were unable to walk postoperatively. Conclusion: A late surgical intervention may not lead to functional recovery in patients with spinal degenerative disease who were unable to walk for at least 6 months.

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“…The reported long-term results of this procedure have been considered satisfactory. [1][2][3][4][5][6][7][8][9][10][11][12] However, a few patients have exhibited late neurological deterioration after good recovery immediately after surgery. Numerous studies have been performed to elucidate the causes of late deterioration after this procedure.…”

Section: Introductionmentioning

confidence: 99%

“…7,10,12,13 Although spondylotic changes including spur formation and disc herniation have occasionally developed in operated segments after laminoplasty, few patients have required additional surgery for treatment of relapse of neurological deficits. [1][2][3][4][6][7][8][9][10][11][12] It is believed that the spinal cord is rarely compressed by spondylotic changes since it is shifted posteriorly in the enlarged spinal canal after laminoplasty.…”

Section: Introductionmentioning

confidence: 99%

Delayed segmental motor paralysis following laminoplasty: two case reports

et al. 2005

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Study design: Two patients who experienced the onset of segmental motor paralysis several years after laminoplasty are presented. Objectives: To discuss the mechanism of development of delayed segmental motor paralysis following laminoplasty. Setting: A department of orthopaedic surgery in Japan. Methods: One patient experienced motor weakness in his deltoid and biceps muscles on the left side 5 years after laminoplasty. The other patient noticed motor weakness in his deltoid and biceps on the right side 7 years after laminoplasty. CT myelography revealed posterior spur formation and hypertrophic facet joints on the hinged side at the C4-C5 level in both patients. Results: Posterior foraminotomy was performed at the C4-C5 level on the hinged side in both patients. Postoperatively, motor weakness in the deltoid and biceps muscles was improved in both patients. Conclusions: Although spondylotic changes, including spur formation and disc herniation, have occasionally developed in operated segments after laminoplasty, few patients have required additional surgery for treatment of relapse of neurological deficits. It has been believed that spinal cord is rarely compressed by the spondylotic changes since it shifts posteriorly in the enlarged spinal canal. However, laminoplasty disturbs the facet joints since the medial portion of dorsal cortex and cancellous bone in facet joints is drilled out to make a trough. Facet joints disturbed in this fashion undergo degeneration over time after surgery. Nerve roots may occasionally be compressed by degenerated facet joints and spurs that have developed at the entrance of root canal, resulting in segmental motor paralysis several years after laminoplasty. Careful long-term observation is necessary after this procedure.

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Operative Results of Canal-Expansive Laminoplasty for Cervical Spondylotic Myelopathy in Elderly Patients

Abstract: The severity of the clinical picture and the duration of symptoms influenced the outcome of the operation. Despite the advanced age of some patients (> 80), the operation increased the chance of recovery from the disease.

Cited by 128 publications

References 12 publications

Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients aged 80 years or older: a multi-center retrospective study

Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients aged 80 years or older: a multi-center retrospective study

Outcome of late surgical treatment in patients with incomplete paraplegia due to spinal degenerative diseases

Delayed segmental motor paralysis following laminoplasty: two case reports

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