PMID- 31888031
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 9
IP  - 1
DP  - 2019 Dec 26
TI  - Degenerative Cervical Myelopathy in Higher-Aged Patients: How Do They Benefit 
      from Surgery?
LID - 10.3390/jcm9010062 [doi]
LID - 62
AB  - 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.
FAU - Gembruch, Oliver
AU  - Gembruch O
AUID- ORCID: 0000-0002-0054-1611
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
FAU - Jabbarli, Ramazan
AU  - Jabbarli R
AUID- ORCID: 0000-0002-8356-6629
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
FAU - Rashidi, Ali
AU  - Rashidi A
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
FAU - Chihi, Mehdi
AU  - Chihi M
AUID- ORCID: 0000-0003-2376-2211
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
FAU - El Hindy, Nicolai
AU  - El Hindy N
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
AD  - Spine-Center Werne, Katholisches Klinikum Lunen/Werne GmbH, St. 
      Christophorus-Krankenhaus, Am See 1, 59368 Werne, Germany.
FAU - Wetter, Axel
AU  - Wetter A
AD  - Institute of Diagnostic and Interventional Radiology and Neuroradiology, 
      University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany.
FAU - Hutter, Bernd-Otto
AU  - Hutter BO
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
FAU - Sure, Ulrich
AU  - Sure U
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
FAU - Dammann, Philipp
AU  - Dammann P
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
FAU - Ozkan, Neriman
AU  - Ozkan N
AD  - Department of Neurosurgery, University Hospital Essen, University of 
      Duisburg-Essen, 45122 Essen, Germany.
LA  - eng
GR  - D/107-40960/University of Duisburg-Essen, IFORES/
PT  - Journal Article
DEP - 20191226
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC7019793
OTO - NOTNLM
OT  - MCID
OT  - cervical canal stenosis
OT  - cervical spine surgery
OT  - degenerative cervical myelopathy
OT  - higher-aged patients
OT  - mJOA Score
OT  - neurological outcome
COIS- The authors declare no conflict of interest.
EDAT- 2020/01/01 06:00
MHDA- 2020/01/01 06:01
PMCR- 2019/12/26
CRDT- 2020/01/01 06:00
PHST- 2019/10/20 00:00 [received]
PHST- 2019/12/17 00:00 [revised]
PHST- 2019/12/24 00:00 [accepted]
PHST- 2020/01/01 06:00 [entrez]
PHST- 2020/01/01 06:00 [pubmed]
PHST- 2020/01/01 06:01 [medline]
PHST- 2019/12/26 00:00 [pmc-release]
AID - jcm9010062 [pii]
AID - jcm-09-00062 [pii]
AID - 10.3390/jcm9010062 [doi]
PST - epublish
SO  - J Clin Med. 2019 Dec 26;9(1):62. doi: 10.3390/jcm9010062.