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Scientific and Radiologic Outcomes of Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy in Aged Sufferers with T2-Weighted Elevated Sign Depth.
World Neurosurg. 2018 Apr;112:e520-e526
Authors: Wei L, Cao P, Xu C, Hu B, Tian Y, Yuan W
Summary
OBJECTIVE: To research scientific and radiologic outcomes of anterior cervical discectomy and fusion for cervical spondylotic myelopathy in aged sufferers with T2-weighted elevated sign depth (ISI), focusing particularly on the quantitative evaluation of ISI.
METHODS: We retrospectively reviewed 88 sufferers with cervical spondylotic myelopathy with ISI who underwent anterior cervical discectomy and fusion with a minimal 1-year follow-up. Sufferers have been divided into 2 teams: sufferers older than 65 (aged group, 36 sufferers) or youthful (younger group, 52 sufferers). The Japanese Orthopaedic Affiliation (JOA) rating was used to judge the neurologic standing. The sign change ratio (SCR) was outlined because the grayscale of ISI area divided by that at C7-T1 disc stage. The C2-C7 sagittal alignment, vary of movement, SCR, and ISI size have been measured.
RESULTS: There was no statistically important distinction between the two teams in C2-C7 sagittal alignment and vary of movement. Nevertheless, the JOA rating at 1-year follow-up and restoration charge in aged group have been considerably decrease than in younger group (P < zero.001). SCR and ISI size have been considerably better in aged group than in younger group, whereas their adjustments have been considerably decrease in aged group (P < zero.05). Multivariate logistic regression evaluation confirmed that an older age, a decrease preoperative JOA rating, a better preoperative SCR, and an extended preoperative ISI size at 1-year follow-up have been negatively correlated with the scientific outcomes within the aged group (P < zero.05).
CONCLUSIONS: In contrast with younger sufferers with ISI, the aged sufferers had a decrease preoperative JOA rating, a better preoperative SCR, and an extended preoperative ISI size, indicating poor surgical outcomes.
PMID: 29366997 [PubMed – indexed for MEDLINE]