Surgery for cervical myelopathy in geriatric patients

N. Razack, J. Greenberg, Barth A Green

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective. The number of geriatric patients seeking surgical treatment for cervical myelopathy is steadily increasing. Although anecdotal experiences have been good, insufficient data exists in the spine literature concerning this particular group. We decided to review our experience to determine efficacy of surgical management and examine our morbidity with this select group. Methods. We undertook a retrospective review of all surgical procedures for nontraumatic cervical myelopathy performed at Mt Sinai Medical Center and Jackson Memorial Medical Center between January 1 1987 and June 1 1992, in patients older than 70 years of age (33 men and 18 women). Results. A total of 53 cervical surgical procedures were performed in 51 patients (nine expansile laminoplasties, 20 anterior cervical diskectomies and fusion and 24 decompressive posterior laminectomies). The average hospital stay was 7.7 ± 3.4 days. Twenty-one (41%) patients required inpatient rehabilitation; the remaining 30 patients received outpatient rehabilitative therapy. The major morbidity rate was 3.9%, and the minor morbidity rate was 5.8%. Perioperative medical complications included cardiac arrhythmias, hypertensive episodes, atelectasis, confusion, urinary dysfunction and hyponatremia. All of these complications resolved except in one patient. The perioperative mortality rate was 2%. Office follow-up was performed for a mean of 11.1 ± 2.5 months postoperatively. Comparison of preoperative and postoperative functional status was performed using Nurick's criteria as described in the literature. At follow-up, 60.8% of the patients had improvement in their myelopathic symptoms, especially in regard to gait; 33.3% were stabilized and 5.9% had worsened neurological function. Conclusion. This study demonstrates that corrective surgical procedures for significant nontraumatic cervical myelopathy in the geriatric population may be performed safely, that is, with acceptable risk of morbidity and reasonable expectation for clinical improvement.

Original languageEnglish
Pages (from-to)629-632
Number of pages4
JournalSpinal Cord
Volume36
Issue number9
StatePublished - Oct 5 1998

Fingerprint

Spinal Cord Diseases
Geriatrics
Morbidity
Diskectomy
Laminectomy
Pulmonary Atelectasis
Hyponatremia
Gait
Cardiac Arrhythmias
Inpatients
Length of Stay
Spine
Outpatients
Rehabilitation
Mortality
Therapeutics
Population

Keywords

  • Cervical spondylitic myelopathy
  • Geriatric
  • Nurick's criteria
  • Surgery

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Razack, N., Greenberg, J., & Green, B. A. (1998). Surgery for cervical myelopathy in geriatric patients. Spinal Cord, 36(9), 629-632.

Surgery for cervical myelopathy in geriatric patients. / Razack, N.; Greenberg, J.; Green, Barth A.

In: Spinal Cord, Vol. 36, No. 9, 05.10.1998, p. 629-632.

Research output: Contribution to journalArticle

Razack, N, Greenberg, J & Green, BA 1998, 'Surgery for cervical myelopathy in geriatric patients', Spinal Cord, vol. 36, no. 9, pp. 629-632.
Razack N, Greenberg J, Green BA. Surgery for cervical myelopathy in geriatric patients. Spinal Cord. 1998 Oct 5;36(9):629-632.
Razack, N. ; Greenberg, J. ; Green, Barth A. / Surgery for cervical myelopathy in geriatric patients. In: Spinal Cord. 1998 ; Vol. 36, No. 9. pp. 629-632.
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