JAMIE PARK, BA: No financial relationships to disclose
Introduction: Degenerative cervical myelopathy (DCM) can cause severe disability if untreated, often going undiagnosed in elderly patients. A retrospective study noted an average delay of 2.2 years from symptom onset to diagnosis, potentially due to subtler symptom presentation in elderly patients.
Methods: This study aims to identify differences in signs, and symptoms between older (≥75 years) and younger ( < 75 years) DCM patients. Patients were selected based on criteria of myelopathy or myeloradiculopathy as surgery indications, with all surgeries performed by Dartmouth Medical Health Center (DHMC) surgeons, and no prior brain, cervical, or thoracic surgery. Retrospective chart reviews evaluated disease severity (mJOA scores) and symptom presentation (weakness, numbness, gait instability).
Results: Mann-Whitney U tests revealed significant differences in mJOA scores for lower extremity motor and sphincter dysfunction between age groups (p=0.0402, 0.0081). Mean lower extremity motor scores were lower in older patients, 5.17 in patients < 75 and 4.14 in those ≥75, while mean upper extremity motor scores were 3.78 and 3.14, respectively. Upper extremity motor and sensation score differences were statistically insignificant (p=0.1723, 0.9363) with mean sensation scores of 2.01 in patients < 75 and 2.0 in those ≥75. Mean sphincter dysfunction scores were 2.78 in patients < 75 and 2.0 in those ≥75. Using Fisher’s Exact test, symptom presentation differences (weakness, numbness, gait instability, positive Rhomberg sign) were not statistically significant between age groups (p=1.0, 0.7007, 0.0992). Weakness and numbness were common in both groups, reported by 78% younger and 79% older patients (weakness) and by 84% younger and 79% older patients (numbness).
Conclusion : Further multivariate analysis may be necessary to fully characterize the relationship between age, disease severity and presenting symptoms. This study may help to promote a tailored diagnosis and rapid treatment of patients with DCM.