Does age-related change affect the short-term postoperative improvement of physical functions and abilities in compressive cervical myelopathy?

Abstract

Aim: This study aimed to clarify whether age-related changes affect the short-term postoperative improvement of physical functions and abilities in compressive cervical myelopathy by comparing elderly and non-elderly cervical myelopathy. Methods: A total of 56 patients with cervical myelopathy who were candidates for surgery (63.1±11.5 years; 40 men, 16 women) were investigated. Written consent to participate in this study was obtained from all participants. The following items were assessed before and/or a month postoperatively; six basic characteristics (Hattori's classification, symptom duration, comorbidity, Pavlof ratio, dynamic instability of cervical spine and cervical intramedullary high intensity change); one motor and one sensory function in the lower and upper extremities, respectively; two walking abilities; one manual dexterity. After division into the elderly group (≥65 years) and non-elderly group (65 years>). basic characteristics, physical functions and abilities were compared between the two groups. Results: The elderly group consisted of 27 participants (72.7±5.2 years; 16 men, 11 women) and the non-elderly group consisted of 29 participants (54.1±8.1 years; 24 men, 5 women). In the 6 preoperative characteristics, the rate of having comorbidity in the elderly group (63.0%) was significantly greater than the non-elderly group (27.6%). Most comobidities were orthopedic disorders. Preoperative motor function in the lower extremity in the elderly group was significantly inferior to the non-elderly group, whereas the improvement rate based on preoperative finding at a month postoperatively was equal to the non-elderly group. Preoperative walking abilities were significantly inferior to the non-elderly group, although their improvement rates were equal to or significantly greater than the non-elderly group. Moreover, preoperative upper extremity motor function and manual dexterity in the elderly group were equal to those in the non-elderly group, and their improvement rates were also equal. Conclusions: Preoperative motor function in the lower extremity and walking abilities in elderly cases of compressive cervical myelopathy were significantly inferior to non-elderly cases of cervical myelopathy, although their improvement rates based on preoperation at one month postoperatively were equal to or significantly greater than non-elderly cases of cervical myelopathy; therefore age-related change is not a directly negative factor for short-term postoperative improvement.