Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients of different ages: a retrospective study

Study design: Retrospective chart audit. Objectives: This study aims to compare the clinical features and surgical outcomes in patients with cervical spondylotic myelopathy (CSM) among different age groups. Setting: The first Affiliated Hospital of Anhui Medical University, China. Methods: A total of 460 patients with CSM who were surgically treated over the period of 1995–2009 were investigated. Considering the peak age (40–60 years old) for the onset of symptoms, we divided the patients into three groups by age: young (<40), middle-aged (40–60), and old (>60). The differences in symptoms, symptom durations, involved levels, surgical approaches and outcomes were evaluated. Results: The number of symptoms and involved levels, symptom duration and posterior approach significantly increased with increasing age, whereas preoperative Japanese Orthopedic Association score decreased among the three groups. Spinal cord function improved after surgery in all groups. The highest degree of recovery occurred during the first 6 months after surgery, especially within the first week, and then reached a plateau. After 6 months, however, recovery continuously improved, stabilized and declined in the young, middle-aged, old groups, respectively. The recovery rate was not significantly different at an immediate period (1 week) after operation among the three groups, but was significantly different at later periods (3 or more months postoperatively). Three groups showed no difference in postoperative complication rates. Conclusion: The severity of CSM increased with increasing age. Age was inversely correlated with recovery, and recovery decreased as age increased. Six months post operation was the prime time for the recovery of spinal cord function.