Differences in postoperative quality of life in young, early elderly, and late elderly patients undergoing surgical treatment for degenerative cervical myelopathy.

dc.contributor.author

Croci, Davide M

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Sherrod, Brandon

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Alvi, Mohammed Ali

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Mummaneni, Praveen V

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Chan, Andrew K

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Bydon, Mohamad

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Glassman, Steven D

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Foley, Kevin T

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Potts, Eric A

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Shaffrey, Mark E

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Coric, Domagoj

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Knightly, John J

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Park, Paul

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Wang, Michael Y

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Fu, Kai-Ming

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Slotkin, Jonathan R

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Asher, Anthony L

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Than, Khoi D

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Gottfried, Oren N

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Shaffrey, Christopher I

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Virk, Michael S

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Bisson, Erica F

dc.date.accessioned

2023-06-15T18:39:52Z

dc.date.available

2023-06-15T18:39:52Z

dc.date.issued

2022-03

dc.date.updated

2023-06-15T18:39:52Z

dc.description.abstract

Objective

Cervical spondylotic myelopathy (CSM) is a common progressive spine disorder affecting predominantly middle-aged and elderly populations. With increasing life expectancy, the incidence of CSM is expected to rise further. The outcomes of elderly patients undergoing CSM surgery and especially their quality of life (QOL) postoperatively remain undetermined. This study retrospectively reviewed patients to identify baseline differences and validated postoperative patient-reported outcome (PRO) measures in elderly patients undergoing CSM surgery.

Methods

The multi-institutional, neurosurgery-specific NeuroPoint Quality Outcomes Database was queried to identify CSM patients treated surgically at the 14 highest-volume sites from January 2016 to December 2018. Patients were divided into three groups: young (< 65 years), early elderly (65-74 years), and late elderly (≥ 75 years). 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 among the groups at baseline and 3 and 12 months postoperatively.

Results

A total of 1151 patients were identified: 691 patients (60%) in the young, 331 patients (28.7%) in the early elderly, and 129 patients (11.2%) in the late elderly groups. At baseline, younger patients presented with worse NDI scores (p < 0.001) and lower EQ-5D VAS (p = 0.004) and EQ-5D (p < 0.001) scores compared with early and late elderly patients. No differences among age groups were found in the mJOA score. An improvement of all QOL scores was noted in all age groups. On unadjusted analysis at 3 months, younger patients had greater improvement in arm pain VAS, NDI, and EQ-5D VAS compared with early and late elderly patients. At 12 months, the same changes were seen, but on adjusted analysis, there were no differences in PROs between the age groups.

Conclusions

The authors' results indicate that elderly patients undergoing CSM surgery achieved QOL outcomes that were equivalent to those of younger patients at the 12-month follow-up.
dc.identifier

2022.1.SPINE211157

dc.identifier.issn

1547-5654

dc.identifier.issn

1547-5646

dc.identifier.uri

https://hdl.handle.net/10161/28034

dc.language

eng

dc.publisher

Journal of Neurosurgery Publishing Group (JNSPG)

dc.relation.ispartof

Journal of neurosurgery. Spine

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10.3171/2022.1.spine211157

dc.subject

Quality Outcomes Database

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age

dc.subject

cervical myelopathy

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cervical spine

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cervical spondylotic myelopathy

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degenerative

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elderly

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patient-reported outcomes

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quality of life

dc.title

Differences in postoperative quality of life in young, early elderly, and late elderly patients undergoing surgical treatment for degenerative cervical myelopathy.

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

1

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11

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3

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Duke

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School of Medicine

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Clinical Science Departments

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Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

pubs.volume

37

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