高齢者に対する脊椎手術 : 手術適応と問題点

概要

論文の詳細を見る
The object of this study was to investigate surgical results and problems associated with spinal surgery in elderly patients (age > 69). Since 1997, we have performed 94 operations in 89 elderly patients (45 men and 44 women with ages ranging from 70-88 years) for cervical (62 cases), thoracic (4 cases), and lumbar lesions (28 cases). Satisfactory improvement as scored on the Neurosurgical Cervical Spine Scale (NCSS) and Japanese Orthopedic Association (JOA) scale was obtained in 64% (60/94). The mortality rate was 2.1% (2/94) (myocardial infarction and heart failure), and the morbidity rate was 6.3% (6/94). Postoperative complications included infection (2), instrumentation failure (2) with one additional repair operation, neurological deterioration (2 cases). The cause of poor the functional outcome was complete cervical cord injury. Postoperative restlessness was seen in 19.1% (18/94). In conclusions, (1) The indication of spinal surgery in aged patients can not be determined only by age because of wide individual differences, (2) The individual patient's volition and comprehension were important as they had a direct influence on the postoperative ADL ; and (3) Surgical procedure performed with interspecialty cooperation was mandatory considering systemic complications. Spinal surgery in elderly patients can be undertaken with acceptable mortality and morbidity by appropriate patient selection.
日本脊髄外科学会の論文
2003-03-31