Cervical spondylotic myelopathy in the aged patient. A radiographic evaluation of the aging changes in the cervical spine and etiologic factors of myelopathy.

Cervical spondylotic myelopathy among older individuals was investigated radiographically in 42 patients over age 60 years, and compared with those of younger patients. The cervical spine in the aged patients displayed dynamic canal stenosis in addition to static canal stenosis based on the aging process. Myelography and computed tomography-myelography showed multisegmental lesions (average: 3.0 lesions), that contributed to the various clinical features of myelopathy. The upper disc levels of C3-4 and C4-5 had a tendency to be involved in the aged patients, and the spinal cords were extensively compressed as compared with the younger patients. Disc protrusion, posterior osteophyte, and retrolisthesis, in addition to ligamentous entrapments were the primary etiologic factors of myelopathy. Morphologically, the high prevalence of cord atrophy was seen on computed tomography-myelography in the aged patients. This indicated severe pathologic changes in the cervical spinal cord, and its prognosis was considered to be poor.