SAN DIEGO — Certain physical signs, such as the absence of patellar tendon reflex hyperreflexia, in elderly patients with cervical myelopathy should not be contraindications to surgery, according to the results of a study presented here.
Takahiko Hamasaki, MD, and colleagues evaluated 100 consecutive patients with cervical myelopathy in three age groups (69 years and younger; 70 years to 79 years; and 80 years and older) and found the postoperative Japanese Orthopaedic Association (JOA) scores in all patient groups showed significant improvement compared with preoperative scores.
“Although pre- and post-op JOA scores and recovery rates are significantly decreased with increasing age, even 80 [years] or older were significantly improved after surgery,” he said at the Cervical Spine Research Society Annual Meeting.
Hamasaki noted the rates of patellar tendon reflex (PTR) hyperreflexia decreased significantly with age. Patients aged 80 years and older had PTR hyperreflexia rates of 59%; patients aged 70 years to 79 years had rates of 85%; and patients aged 69 years and younger had rates of 91%.
Patients with higher rates of PTR hyperreflexia had significantly higher preoperative JOA scores than patients with lower rates of PTR hyperreflexia. However, patients with lower rates of PTR hyperreflexia also experienced significantly improved JOA scores postoperatively.
Hamasaki concluded the lack of PTR hyperreflexia should not be a contraindication to surgery in elderly patients with cervical myelopathy, and physicians should consider other physical signs and imaging findings in their surgical decision-making for this cohort. – by Robert Linnehan
Hamasaki T. Presentation #5. Presented at: Cervical Spine Research Society Annual Meeting; Dec. 3-5, 2015; San Diego.
Disclosure: Hamasaki reports no relevant financial disclosures.