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The Journal of Bone & Joint Surgery British Volume
Vol. 82-B, Issue 2 | Pages 269 - 274
1 Mar 2000
Tani T Ishida K Ushida T Yamamato H

We treated 31 patients aged 65 years or more with cervical spondylotic myelopathy by microsurgical decompression and fusion at a single most appropriate level, in spite of MRI evidence of compression at several levels. Spinal cord potentials evoked at operation localised the level responsible for the principal lesion at C3-4 in 18 patients, C4-5 in 11 and at C5-6 in two. Despite the frequent coexistence of other age-related conditions, impairing ability to walk, the average Nurick grade improved from 3.5 before operation to 2.2 at a mean follow-up of 48 months. There was also good recovery of finger dexterity and sensitivity.

Operation at a single optimal level, as opposed to several, has the advantage of minimising complications, of particular importance in this age group.