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Updated: May 27, 2026
06:11
Anterior Cervical Discectomy and Fusion in the Ovine Model
Published on: October 5, 2009
Occipitocervical fusion in elderly patients.
Michelle J Clarke1, L Gerard Toussaint, Ramesh Kumar
1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. clarke.michelle@mayo.edu
World Neurosurgery
|November 29, 2011
Summary
Occipitocervical fusion (OCF) can stabilize neurological deficits in elderly patients with occipitocervical disease (OCD). The posterior approach offers better outcomes and fewer complications, especially for those with poor preoperative function.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Geriatric Medicine
Background:
- Occipitocervical disease (OCD) is increasingly prevalent in the aging population.
- Occipitocervical fusion (OCF) outcomes in elderly patients can be mixed.
- OCF is a potential intervention for managing OCD in older adults.
Purpose of the Study:
- To evaluate the outcomes of occipitocervical fusion (OCF) in elderly patients with occipitocervical disease (OCD).
- To compare the efficacy and safety of different surgical approaches (posterior vs. anterior/posterior) for OCF in this demographic.
- To identify predictors of neurologic improvement following OCF in older adults.
Main Methods:
- Retrospective review of 20 consecutive patients over 65 undergoing OCF between 1995 and 2005.
- Analysis of demographic, presentation, surgical, and outcome data.
- Assessment of functional scores including modified Japanese Orthopedic Association, Ranawat Myelopathy Score, and Nurick Myelopathy Grade.
Main Results:
- OCF modestly improved function across multiple metrics (mJOA, Ranawat, Nurick scores).
- Patients with poorer preoperative function (Ranawat grade ≥ III) showed significantly greater neurologic improvement.
- The posterior surgical approach resulted in better functional outcomes and fewer complications compared to anterior/posterior approaches.
Conclusions:
- OCF may be necessary to prevent or stabilize neurologic deficits in elderly patients with OCD.
- The posterior surgical approach is favored in the elderly population due to improved outcomes and safety profile.
- Elderly patients with poor preoperative function may experience greater neurologic benefits from OCF.
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