Cervical spondylotic myelopathy (CSM) is a common degenerative spine illness that affects middle-aged and older people. CSM is likely to become more common as people live longer lives. The prognosis of older people receiving CSM surgery, particularly their postoperative quality of life (QOL), is unknown. A study retrospectively analyzed older patients receiving CSM surgery to determine baseline differences and validate postoperative patient-reported outcome (PRO) measures. From January 2016 to December 2018, the multi-institutional, neurosurgery-specific NeuroPoint Quality Outcomes Database was queried by Researchers to identify CSM patients treated surgically at the 14 highest-volume facilities. Patients were separated into three groups: those under the age of 65, those between the ages of 65 and 74, and those over 75. At baseline, 3 and 12 months postoperatively, demographic and PRO measures (Neck Disability Index [NDI] score, modified Japanese Orthopaedic Association [mJOA] score, EQ-5D score, EQ-5D visual analog scale [VAS] score, arm pain VAS, and neck pain VAS) were compared by investigators across groups.
A total of 1151 individuals were found, with 691 patients (60%) being young, 331 patients (28.7%) being early elderly, and 129 patients (11.2%) being late elderly. When compared to early and late elderly patients, younger patients had lower NDI scores (p<0.001) and lower EQ-5D VAS (p=0.004) and EQ-5D (p<0.001) ratings at baseline. The mJOA score showed no variations between age groups. In all age categories, there was an improvement in all QOL scores. In an unadjusted study at 3 months, younger patients improved more in arm pain VAS, NDI, and EQ-5D VAS than early and late old patients. The same alterations were observed after 12 months, although there were no differences in PROs on adjusted analyses. The authors’ findings show that at the 12-month follow-up, older patients undergoing CSM surgery had QOL outcomes comparable to younger patients.
