[Does age-related change affect the short-term postoperative improvement of physical functions and abilities in compressive cervical myelopathy?].

AIM

This study aimed to clarify whether age-related changes affect the short-term postoperative improvement of physical functions and abilities in compressive cervical myelopathy by comparing elderly and non-elderly cervical myelopathy.

METHODS

A total of 56 patients with cervical myelopathy who were candidates for surgery (63.1+/-11.5 years; 40 men, 16 women) were investigated. Written consent to participate in this study was obtained from all participants. The following items were assessed before and/or a month postoperatively; six basic characteristics (Hattori's classification, symptom duration, comorbidity, Pavlof ratio, dynamic instability of cervical spine and cervical intramedullary high intensity change); one motor and one sensory function in the lower and upper extremities, respectively; two walking abilities; one manual dexterity. After division into the elderly group (> or =65 years) and non-elderly group (65 years>). basic characteristics, physical functions and abilities were compared between the two groups.

RESULTS

The elderly group consisted of 27 participants (72.7+/-5.2 years; 16 men, 11 women) and the non-elderly group consisted of 29 participants (54.1+/-8.1 years; 24 men, 5 women). In the 6 preoperative characteristics, the rate of having comorbidity in the elderly group (63.0%) was significantly greater than the non-elderly group (27.6%). Most comobidities were orthopedic disorders. Preoperative motor function in the lower extremity in the elderly group was significantly inferior to the non-elderly group, whereas the improvement rate based on preoperative finding at a month postoperatively was equal to the non-elderly group. Preoperative walking abilities were significantly inferior to the non-elderly group, although their improvement rates were equal to or significantly greater than the non-elderly group. Moreover, preoperative upper extremity motor function and manual dexterity in the elderly group were equal to those in the non-elderly group, and their improvement rates were also equal.

CONCLUSIONS

Preoperative motor function in the lower extremity and walking abilities in elderly cases of compressive cervical myelopathy were significantly inferior to non-elderly cases of cervical myelopathy, although their improvement rates based on preoperation at one month postoperatively were equal to or significantly greater than non-elderly cases of cervical myelopathy; therefore age-related change is not a directly negative factor for short-term postoperative improvement.