80歳以上の高齢者頚髄症に対する頚椎椎弓形成術の術後成績

Surgical Result of Open Door Laminoplasty for Cervical Myelopathy in 80-Year or Older Patients

　高齢者頚髄症の治療上の問題点を明らかにするために，当院で加療した80歳代（20例）と60歳代（19例）の患者を対象とし，術前後のJOAスコア，責任高位，既往症，術後合併症の有無について比較検討した．JOAスコアは80歳代が平均10.5点から13.1点（改善率40.5％）に，60歳代は12.8点から15.1点（改善率53.9％）に改善した．80歳代では90％の症例に合併症を有していたが，譫妄などの明らかな術後合併症はなかった．周術期管理を徹底すれば高齢者でも安全に手術が可能で，良好な結果が得られた．

　We verified complications in elderly patients undergoing open-door laminoplasty for myelopathy. We compared 20 in their 80s to 19 in their 60s based on postoperative Japanese Orthopedic Association scores. We also assessed main lesions, illnesses, and postoperative complications. Those in their 80s had JOA scores improved from an average 10.5 points to 13.1 points (recovery 40.5％). Those in their 60s improved from 12.8 points to 15.1 points (recovery 53.9％). Although 90％ of those in their 80s had complications, none had postoperative complications such as delirium. Even elderly patients can thus be operated on safely with good results when management is appropriate.