Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Sep 2008
Comparative StudySurgical treatment of cervical spondylosis in the elderly: surgical outcomes, risk factors, and complications.
The incidence of cervical spondylosis in the elderly is increasing with the higher proportion of elderly individuals among the Japanese population. The present study retrospectively analyzed the clinical and radiological features of this clinical entity in 107 patients with cervical spondylosis aged 70 years or older surgically treated between 1995 and 2005. The patients were divided into Group 1 (n = 60) aged between 70 and 74 years, and Group 2 (n = 47) 75 years or older. ⋯ Surgical decompression for cervical spondylosis is beneficial even in elderly patients. Single-level anterior fusion to treat the lesion most responsible for the symptoms is the least invasive choice. Elderly patients tend to present with multiple risk factors so require careful perioperative management.
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Percutaneous endoscopic lumbar discectomy (PELD) is one of the surgical options for soft lumbar disk herniation, but the learning curve is perceived to be steep. The first 51 PELD cases performed for single-level intracanalicular lumbar disk herniation causing radiculopathy by the same surgeon were prospectively studied. The patients were divided into 3 groups of 17 patients, and the PELD learning curve was assessed by evaluating operating time, failure rate, complication rate, and 1-year reherniation rate. ⋯ No significant differences were observed in terms of either failure rate or complication rate between the 3 groups. No significant differences were observed in terms of either the clinical success rate or the reherniation rate at 1 year after surgery. The PELD learning curve seems to be stable and acceptable with proper pre-PELD training.