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Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit from Surgery?

Background: Degenerative cervical myelopathy (DCM) is the most common reason for spinal cord disease in elderly patients. This study analyzes the preoperative status and postoperative outcome of higher-aged patients in comparison to young and elderly patients in order to determine the benefit to tho...

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Autores principales: Gembruch, Oliver, Jabbarli, Ramazan, Rashidi, Ali, Chihi, Mehdi, El Hindy, Nicolai, Wetter, Axel, Hütter, Bernd-Otto, Sure, Ulrich, Dammann, Philipp, Özkan, Neriman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019793/
https://www.ncbi.nlm.nih.gov/pubmed/31888031
http://dx.doi.org/10.3390/jcm9010062
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author Gembruch, Oliver
Jabbarli, Ramazan
Rashidi, Ali
Chihi, Mehdi
El Hindy, Nicolai
Wetter, Axel
Hütter, Bernd-Otto
Sure, Ulrich
Dammann, Philipp
Özkan, Neriman
author_facet Gembruch, Oliver
Jabbarli, Ramazan
Rashidi, Ali
Chihi, Mehdi
El Hindy, Nicolai
Wetter, Axel
Hütter, Bernd-Otto
Sure, Ulrich
Dammann, Philipp
Özkan, Neriman
author_sort Gembruch, Oliver
collection PubMed
description Background: Degenerative cervical myelopathy (DCM) is the most common reason for spinal cord disease in elderly patients. This study analyzes the preoperative status and postoperative outcome of higher-aged patients in comparison to young and elderly patients in order to determine the benefit to those patients from DCM surgery. Methods: A retrospective analysis of the clinical data, radiological findings, and operative reports of 411 patients treated surgically between 2007 and 2016 suffering from DCM was performed. The preoperative and postoperative neurological functions were evaluated using the modified Japanese Orthopedic Association Score (mJOA Score), the postoperative mJOA Score improvement, the neurological recovery rate (NRR) of the mJOA Score, and the minimum clinically important difference (MCID). The Charlson Comorbidity Index (CCI) was used to evaluate the impact of comorbidities on the preoperative and postoperative mJOA Score. The comparisons were performed between the following age groups: G1: ≤50 years, G2: 51–70 years, and G3: >70 years. Results: The preoperative and postoperative mJOA Score was significantly lower in G3 than in G2 and G1 (p < 0.0001). However, the mean mJOA Score’s improvement did not differ significantly (p = 0.81) between those groups six months after surgery (G1: 1.99 ± 1.04, G2: 2.01 ± 1.04, G: 2.00 ± 0.91). Furthermore, the MCID showed a significant improvement in every age-group. The CCI was evaluated for each age-group, showing a statistically significant group effect (p < 0.0001). Analysis of variance revealed a significant group effect on the delay (weeks) between symptom onset and surgery (p = 0.003). The duration of the stay at the hospital did differ significantly between the age groups (p < 0.0001). Conclusion: Preoperative and postoperative mJOA Scores, but not the extent of postoperative improvement, are affected by the patients’ age. Therefore, patients should be considered for DCM surgery regardless of their age.
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spelling pubmed-70197932020-03-09 Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit from Surgery? Gembruch, Oliver Jabbarli, Ramazan Rashidi, Ali Chihi, Mehdi El Hindy, Nicolai Wetter, Axel Hütter, Bernd-Otto Sure, Ulrich Dammann, Philipp Özkan, Neriman J Clin Med Article Background: Degenerative cervical myelopathy (DCM) is the most common reason for spinal cord disease in elderly patients. This study analyzes the preoperative status and postoperative outcome of higher-aged patients in comparison to young and elderly patients in order to determine the benefit to those patients from DCM surgery. Methods: A retrospective analysis of the clinical data, radiological findings, and operative reports of 411 patients treated surgically between 2007 and 2016 suffering from DCM was performed. The preoperative and postoperative neurological functions were evaluated using the modified Japanese Orthopedic Association Score (mJOA Score), the postoperative mJOA Score improvement, the neurological recovery rate (NRR) of the mJOA Score, and the minimum clinically important difference (MCID). The Charlson Comorbidity Index (CCI) was used to evaluate the impact of comorbidities on the preoperative and postoperative mJOA Score. The comparisons were performed between the following age groups: G1: ≤50 years, G2: 51–70 years, and G3: >70 years. Results: The preoperative and postoperative mJOA Score was significantly lower in G3 than in G2 and G1 (p < 0.0001). However, the mean mJOA Score’s improvement did not differ significantly (p = 0.81) between those groups six months after surgery (G1: 1.99 ± 1.04, G2: 2.01 ± 1.04, G: 2.00 ± 0.91). Furthermore, the MCID showed a significant improvement in every age-group. The CCI was evaluated for each age-group, showing a statistically significant group effect (p < 0.0001). Analysis of variance revealed a significant group effect on the delay (weeks) between symptom onset and surgery (p = 0.003). The duration of the stay at the hospital did differ significantly between the age groups (p < 0.0001). Conclusion: Preoperative and postoperative mJOA Scores, but not the extent of postoperative improvement, are affected by the patients’ age. Therefore, patients should be considered for DCM surgery regardless of their age. MDPI 2019-12-26 /pmc/articles/PMC7019793/ /pubmed/31888031 http://dx.doi.org/10.3390/jcm9010062 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gembruch, Oliver
Jabbarli, Ramazan
Rashidi, Ali
Chihi, Mehdi
El Hindy, Nicolai
Wetter, Axel
Hütter, Bernd-Otto
Sure, Ulrich
Dammann, Philipp
Özkan, Neriman
Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit from Surgery?
title Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit from Surgery?
title_full Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit from Surgery?
title_fullStr Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit from Surgery?
title_full_unstemmed Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit from Surgery?
title_short Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit from Surgery?
title_sort degenerative cervical myelopathy in higher-aged patients: how do they benefit from surgery?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019793/
https://www.ncbi.nlm.nih.gov/pubmed/31888031
http://dx.doi.org/10.3390/jcm9010062
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