El-Hajj Victor Gabriel, Staartjes Victor E, Charalampidis Anastasios, Nilsson Gunnar, Gerdhem Paul, Edström Erik, Elmi-Terander Adrian, Åkerstedt Josefin
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Eur Spine J. 2025 May 10. doi: 10.1007/s00586-025-08890-1.
Global demographics show a steady increase in the number of octogenarians. Consequently, the number of degenerative spine procedures in the elderly has significantly increased. This study aims to describe patient satisfaction, the patient-reported health-related quality-of-life, and complications, following posterior cervical laminectomy for degenerative cervical myelopathy (DCM) in octogenarians based on the national Swedish experience.
The national Swedish spine registry, Swespine was reviewed between January 2006 and December 2020 for patients who underwent laminectomy for DCM. Complication rates, patient satisfaction, and Patient-Reported Outcome Measures (PROMs) one year after surgery, were analyzed and compared between propensity score matched octogenarian (≥ 80) and younger adult cohorts (< 80 years).
A total of 1,382 patients, 162 octogenarians, and 1,220 younger patients were identified. At one-year after surgery there were no significant difference in patient satisfaction rate or in any of the other PROMS (Eq. 5D, NRS neck pain, NRS arm pain, EQ-VAS, Neck Disability Index (NDI), the European Myelopathy Score (EMS). Complication rates were also comparable, 8.0% in octogenarians (n = 13) and 11% in younger adults (n = 51), respectively. The length of hospital stay was significantly longer in the octogenarian group, with a mean hospitalization of 5.08 days (SD ± 4.86) compared to 3.76 days (SD ± 3.93) in the younger adult cohort (p < 0.001).
Octogenarians undergoing cervical spine surgery for DCM experience outcomes comparable to younger adults in terms of satisfaction, pain relief, and quality of life, indicating that age alone should not hinder surgical treatment.
IV, Retrospective observational cohort study.
全球人口统计数据显示，八旬老人的数量在稳步增加。因此，老年患者退行性脊柱手术的数量显著增加。本研究旨在基于瑞典的全国经验，描述八旬老人因退行性颈椎脊髓病（DCM）接受颈椎后路椎板切除术后的患者满意度、患者报告的健康相关生活质量和并发症情况。
回顾瑞典全国脊柱登记系统Swespine在2006年1月至2020年12月期间接受DCM椎板切除术的患者。分析并比较倾向评分匹配的八旬老人（≥80岁）和年轻成人队列（<80岁）术后一年的并发症发生率、患者满意度和患者报告结局指标（PROMs）。
共确定了1382例患者，其中162例为八旬老人，1220例为年轻患者。术后一年，患者满意度或任何其他PROMs（Eq. 5D、NRS颈部疼痛、NRS手臂疼痛、EQ-VAS、颈部残疾指数（NDI）、欧洲脊髓病评分（EMS））均无显著差异。并发症发生率也相当，八旬老人为8.0%（n = 13），年轻成人为11%（n = 51）。八旬老人组的住院时间明显更长，平均住院时间为5.08天（标准差±4.86），而年轻成人队列的平均住院时间为3.76天（标准差±3.93）（p < 0.001）。
因DCM接受颈椎手术的八旬老人在满意度、疼痛缓解和生活质量方面的结果与年轻成人相当，这表明年龄本身不应成为手术治疗的障碍。
IV，回顾性观察队列研究。
