Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakai, Japan.
Department of Orthopedic Surgery, Sumitomo Hospital, Osaka, Japan.
Global Spine J. 2015 Apr;5(2):118-23. doi: 10.1055/s-0034-1396759. Epub 2014 Dec 8.
Study Design Retrospective clinical study. Objective To investigate the age-related surgical outcomes of laminoplasty. Methods One hundred patients who underwent an en bloc laminoplasty for cervical spondylotic myelopathy from 2004 to 2008 and were followed for at least 1 year were included in this study. The clinical outcomes were assessed with the Japanese Orthopaedic Association (JOA) score. Acquired points (postoperative JOA score minus preoperative JOA score) were also calculated. To investigate the age-related effect for laminoplasty, two analyses were conducted: (1) the correlation between age and clinical outcome; and (2) the clinical outcomes by decade. Patients were divided into four groups according to their age at the time of operation as follows: group 50s, 50 to 59 years old; group 60s, 60 to 69 years; group 70s, 70 to 79 years; and group 80s, 80 to 89 years. The pre- and postoperative JOA scores, acquired points, preoperative comorbidities, and postoperative complications were then compared among the groups. Results Significant correlations were detected between age and JOA scores at the preoperative (p = 0.03), postoperative maximum (p < 0.0001), and final assessments (p < 0.0001). An age-related decline of JOA scores was observed over all periods. The analysis by decades showed the same results. On the other hand, the significant differences were not found for acquired points over all periods by either method. The preoperative comorbidities of hypertension and diabetes mellitus increased with age. Delirium was more common postoperatively in elderly patients. Conclusions Although an age-related decline of JOA scores was found over all periods, there were no severe sequelae and no differences in the acquired points that were age-related.
回顾性临床研究。目的：探讨颈椎管狭窄症患者行单开门椎管扩大成形术的年龄相关手术结果。方法：本研究纳入了 2004 年至 2008 年间因颈椎脊髓病而行整块单开门椎管扩大成形术且至少随访 1 年的 100 例患者。采用日本骨科协会（JOA）评分评估临床疗效。还计算了获得的分数（术后 JOA 评分减去术前 JOA 评分）。为了研究年龄相关的影响，进行了两项分析：（1）年龄与临床结果的相关性；（2）按十年划分的临床结果。根据手术时的年龄，患者分为以下四组：50 岁组（50-59 岁）、60 岁组（60-69 岁）、70 岁组（70-79 岁）和 80 岁组（80-89 岁）。然后比较了各组的术前和术后 JOA 评分、获得的分数、术前合并症和术后并发症。结果：术前（p=0.03）、术后最大（p<0.0001）和最终评估（p<0.0001）时，年龄与 JOA 评分均存在显著相关性。在所有时间段，JOA 评分均随年龄呈下降趋势。按十年划分的分析也得出了相同的结果。另一方面，两种方法均未发现获得的分数在所有时间段存在显著差异。高血压和糖尿病的术前合并症随年龄增加而增加。术后老年患者更易发生谵妄。结论：尽管在所有时间段均发现 JOA 评分呈年龄相关下降，但无严重后遗症，且与年龄相关的获得分数无差异。
