Abstract

Background

The aim of this study was to investigate whether clinical outcomes in patients aged ≥ 70 undergoing decompressive surgery for degenerative cervical myelopathy (DCM) differ from those of younger patients (50–70 years) at 1 year.

Methods

Data were obtained from the Norwegian Registry for Spine Surgery (NORspine). Among 651 patients included, 177 (27.2%) were ≥ 70 years old. The primary outcome was change in the Neck Disability Index (NDI). Secondary outcomes were changes in the European Myelopathy Score (EMS), quality of life (EuroQoL EQ-5D), numeric rating scales (NRS) for headache, neck pain, and arm pain, and complications.

Results

Significant improvements in all patient-reported outcomes (PROMs) were detected for both age cohorts at 1 year. For the two age cohorts combined, there was a statistically significant improvement in the NDI score (mean 9.2, 95% CI 7.7 to 10.6, P < 0.001). There were no differences between age cohorts in mean change of NDI (− 8.9 vs. − 10.1, P = 0.48), EQ-5D (0.13 vs. 0.17, P = 0.37), or NRS pain scores, but elderly patients experienced a larger improvement in EMS (0.7 vs. 1.3, P = 0.02). A total of 74 patients (15.6%) in the younger cohort and 43 patients (24.3%) in the older cohort experienced complications or adverse effects within 3 months of surgery, mainly urinary and respiratory tract infections.

Conclusion

Surgery for DCM was associated with significant improvement across a wide range of PROMs for both younger and elderly patients. Surgery for DCM should not be denied based on age alone.

Details

Title
Surgery for degenerative cervical myelopathy in the elderly: a nationwide registry-based observational study with patient-reported outcomes
Author
Johansen, Tonje Okkenhaug 1   VIAFID ORCID Logo  ; Vangen-Lønne, Vetle 1 ; Holmberg, Siril T. 1 ; Salvesen, Øyvind O. 2 ; Solberg, Tore K. 3 ; Gulati, Agnete M. 4 ; Nygaard, Øystein P. 5 ; Gulati, Sasha 1 

1  Norwegian University of Science and Technology, Department of Neuromedicine and Movement Science, Trondheim, Norway (GRID:grid.5947.f) (ISNI:0000 0001 1516 2393); St. Olavs Hospital, Department of Neurosurgery, Trondheim, Norway (GRID:grid.52522.32) (ISNI:0000 0004 0627 3560) 
2  Norwegian University of Science and Technology, Department of Public Health and General Practice, Trondheim, Norway (GRID:grid.5947.f) (ISNI:0000 0001 1516 2393) 
3  University Hospital of North Norway, Department of Neurosurgery and the Norwegian Registry for Spine Surgery, Tromsø, Norway (GRID:grid.412244.5) (ISNI:0000 0004 4689 5540); UNN The Arctic University of Norway, Institute for Clinical Medicine, Tromsø, Norway (GRID:grid.10919.30) (ISNI:0000000122595234) 
4  St. Olavs Hospital, Department of Rheumatology, Trondheim, Norway (GRID:grid.52522.32) (ISNI:0000 0004 0627 3560) 
5  Norwegian University of Science and Technology, Department of Neuromedicine and Movement Science, Trondheim, Norway (GRID:grid.5947.f) (ISNI:0000 0001 1516 2393); St. Olavs Hospital, Department of Neurosurgery, Trondheim, Norway (GRID:grid.52522.32) (ISNI:0000 0004 0627 3560); St. Olavs Hospital, National Advisory Unit On Spinal Surgery, Trondheim, Norway (GRID:grid.52522.32) (ISNI:0000 0004 0627 3560) 
Pages
2317-2326
Publication year
2022
Publication date
Sep 2022
Publisher
Springer Nature B.V.
ISSN
00016268
e-ISSN
09420940
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1007/s00701-022-05282-y
ProQuest document ID
2708083985
Copyright
© The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.