Surgical Treatment of Cervical Spondylosis in the Elderly: Surgical Outcomes, Risk Factors, and Complications

Abstract

The incidence of cervical spondylosis in the elderly is increasing with the higher proportion of elderly individuals among the Japanese population. The present study retrospectively analyzed the clinical and radiological features of this clinical entity in 107 patients with cervical spondylosis aged 70 years or older surgically treated between 1995 and 2005. The patients were divided into Group 1 (n ＝ 60) aged between 70 and 74 years, and Group 2 (n ＝ 47) 75 years or older. Patients with localized compression within 2 levels responsible for the neurological symptoms underwent anterior fusion, and patients with a narrow spinal canal were treated by laminoplasty. The pre-and postoperative neurological status (Neurosurgical Cervical Spine Scale) and postoperative complications were compared. More patients in Group 2 required laminoplasty but most patients underwent single-level anterior fusion. There was no statistically significant difference in the surgical results. Group 2 had a much higher ratio of anterior fusion at the C3-4 level. Many of the aged patients had multiple risk factors. Surgical decompression for cervical spondylosis is beneficial even in elderly patients. Single-level anterior fusion to treat the lesion most responsible for the symptoms is the least invasive choice. Elderly patients tend to present with multiple risk factors so require careful perioperative management.

Effects of Remote Ischemic Preconditioning on Biochemical Markers and Neurologic Outcomes in Patients Undergoing Elective Cervical Decompression Surgery

“…According to previous reports, the incidence of neurologic complications after cervical decompression surgery (paresis, palsy, etc) due to spinal cord ischemia-reperfusion injury ranges from 2% to 5.7%. 3,4 Ischemic preconditioning (IPC) is proven to minimize ischemia-reperfusion injury in many organs including the spinal cord in animal models. 5,6 Unfortunately, the idea of exposure to brief periods of ischemia before an anticipated spinal cord ischemic event is not clinically practical.…”

Anterior and Posterior Approach Results for Treatment of Cervical Myelopathy in the Elderly: A 10-Year Experience in a Mexican Institution

“…The recommendation is to start the conservative treatment in patients with mild CDSD [18]. The proportion of patients who converted to surgery after failed nonoperative care ranged from 4% to 40% during 3 of 7 years [5].…”

“…Elderly patients with CM often present with a multilevel disease, the literature considers the treatment with laminoplasty rather than anterior fusion in case of failure of the conservative therapy [5]. This is the first research that describes and compares the outcomes between the Anterior Approach (AA) and Posterior Approach (PA) to treat CM in the elderly in the Mexican population [6].…”

Musculoskeletal Systems

“…It is a common condition [ 16 ], and its incidence is increasing [ 17 ] and is a frequent cause of spinal cord dysfunction and nerve root compression in the elderly. It increases with age and affects both men and women.…”