老年人脊髓型颈椎病的手术治疗

目的 探讨老年人脊髓型颈椎病手术及围手术期特点。方法 回顾性分析了32例老年人脊髓型颈椎病临床资料，术前JOA评分为3～14分，平均5．8分。32例均行颈前路减压，植骨融合术，其中20例行自锁钢板内固定。结果 32例中随访27例，时间4～60个月，平均29．4个月，JOA评分5～17分，平均10．5分，改善率为9．2～82．40％，平均71．82％。Odom’s临床疗效评定标准：优6例，良13例，好转5例，差3例，优良率70．37％。结论 重视老年人术前危险情况的针对性处理，选择好手术时机，术后密切观察病情变化。对老年人CSM术前全面客观的评价，有助于减少手术并发症，使手术更加安全可靠。

Surgical treatment of cervical spondylotic myelopathy in the elderly

Objective To study the characteristics of operative treatment and perioperative period of cervical spondylotic myelopathy (CSM) in the elderly.Methods The data of 32 cases of CSM were analyzed retrospectively. JOA score ranged from 3 to 14 points with an average of 5.8 before operation. All the cases were treated with anterior decompression and bone graft, 20 of them were stabilized with anterior locking plate.Results 27 cases were followed up after operation from 4 to 60 months (average 29.4 months). After operation the mean JOA score ranged from 5 to 17 points, with an average of 10.5, and in average the recovery rate was 71.82% from 9.2% to 82.40%. Odom's functional evaluation revealed excellent in 6 cases of 27, 13 good, 5 fair, 3 poor. The excellent and good rate was 70.37%.Conclusion Pay attention to the correspondent preoperative treatment with dangerous situations of the senile.Choose appropriate time for surgery. Carefully and closely observe the change of the patient's situation after the surgery. Make a systemic and objective assessment of CSM before operation, try best to decrease the surgical complications, making the surgery much safer and more reliable.