Clinical and Radiological Results of Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy in Elderly Patients with T2-Weighted Increased Signal Intensity.

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Clinical and Radiological Results of Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy in Elderly Patients with T2-Weighted Increased Signal Intensity.

World Neurosurg. 2018 Jan 20;:

Authors: Wei L, Cao P, Xu C, Hu B, Tian Y, Yuan W

Abstract
OBJECTIVE: To investigate clinical and radiological results of anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM) in elderly patients with T2-weighted increased signal intensity (ISI), focusing specifically on the quantitative analysis of ISI.
METHODS: We retrospectively reviewed 88 CSM patients with ISI who underwent ACDF with a minimum 1-year follow-up. Patients were divided into 2 groups: patients older than 65 (elderly group, 36 patients) or not (young group, 52 patients). The Japanese Orthopedic Association (JOA) score was used to evaluate the neurological status. The signal change ratio (SCR) was defined as the gray scale of ISI region divided by that at C7-T1 disc level. The C2-C7 sagittal alignment, range of motion (ROM), SCR, and ISI length were measured.
RESULTS: There was no statistically significant difference between two groups in C2-C7 sagittal alignment and ROM. However, the JOA score at 1-year follow-up and recovery rate in elderly group were significantly lower than in young group (P＜0.001). SCR and ISI length were significantly higher in elderly group than in young group, while their changes were significantly lower in elderly group (P＜0.05). Multivariate logistic regression analysis showed that an older age, a lower preoperative JOA score, a higher preoperative SCR, and a longer preoperative ISI length at 1-year follow-up were negatively correlated with the clinical outcomes in elderly group (P＜0.05).
CONCLUSIONS: Compared to young patients with ISI, the elderly patients had a lower preoperative JOA score, a higher preoperative SCR, and a longer preoperative ISI length, indicating poor surgical outcomes.

PMID: 29366997 [PubMed - as supplied by publisher]

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