CLINICAL ARTICLE - FUNCTIONAL The dependence of age on ulnar nerve conductive study parameter adaptation after compressive ulnar neuropathy operations in the elbow Novotná Radka 1 & Vyšata Oldřich 1 & Ehler Edvard 2 & Kanta Martin 1 & Schreiber Martin 3 & Procházka Aleš 4 & Pavel Kunc 1 & Vališ Martin 1 Received: 28 April 2015 /Accepted: 17 June 2015 /Published online: 2 July 2015 # Springer-Verlag Wien 2015 Abstract Background According to some studies, peripheral nerve in- jury healing is prolonged in elderly patients. Compressive ulnar neuropathy in the elbow (UNE) is the second most com- mon compressive mononeuropathy. To our knowledge, no study has investigated the effect of age on the postoperative ulnar nerve injury repair rate. Our aim was to evaluate age- related differences in the electrophysiological parameters be- fore and approximately 100 days after operations for cubital tunnel syndrome. Methods This retrospective study included 103 patients who underwent in situ ulnar nerve decompressions in the elbow. The included patients suffered from paraesthesia and hypoesthesia in their ulnar nerve distribution, hypertrophy, and weakening of the hand muscles, which were innervated by the ulnar nerve. Concurrently, these patients met the EGM diagnostic criteria for UNE. The age dependency on the dif- ferences between the preoperative and postoperative parame- ter values that were measured during the conductive studies was estimated using a regression analysis. Results A statistically significant deceleration of the moni- tored parameter adaptation, which included segmental con- duction velocity in the elbow area and CMAP amplitude dur- ing the above-elbow stimulation of the ulnar nerve, was found. Conclusions Ulnar nerve injury repair in the cubital tunnel area after a UNE operation proceeds significantly slower in elderly patients. Keywords Compressive ulnar neuropathy at the elbow . Ulnar nerve . Nerve conduction studies . Cubital canal/tunnel in situ decompression . Age-dependent recovery Introduction Aging significantly affects some morphological and function- al characteristics of the peripheral nervous system. Motor and sensory axons, which have the highest conductivity (they in- nervate type II muscle fibers), disappear the fastest with age. Conduction velocities decrease at an average rate of 0.5–4 m/s per decade. Past the age of 60, motor and sensory summation potential amplitudes decline significantly with age. Converse- ly, motor unit action potential durations increase. This is prob- ably due to reinnervation after motor axon loss. Beginning in the third decade of life, approximately 1 % of motor units are lost per year. Their loss is accelerated even more at ages over 60 [7]. The absence of Achilles tendon reflex and reduced vibratory sensation were found in 26 % of tested healthy sub- jects aged 74–84 years and in 54 % of individuals over 85. Morphological studies showed a loss of both myelinated and unmyelinated fibers in elderly individuals. Reduced expres- sion of the major myelin proteins and decreased expression and axonal transport of cytoskeletal proteins were found in the peripheral nerve [8]. In healthy individuals aged 65–90 years, * Vališ Martin valismar@seznam.cz 1 Department of Neurology, Faculty of Medicine in Hradec Králové, University Hospital Hradec Králové, Charles University in Prague, Sokolská 581, 500 05 Hradec Králové, Czech Republic 2 Department of Neurology, Regional Hospital and Faculty of Health Studies, University of Pardubice, Kyjevská 44, 532 03 Pardubice, Czech Republic 3 EMG laboratory, Bří Štefanů 895, 500 03 Hradec Králové, Czech Republic 4 Department of Computing and Control Engineering, Institute of Chemical Technology, Technická 5, 166 28 Prague 6, Czech Republic Acta Neurochir (2015) 157:1405–1409 DOI 10.1007/s00701-015-2489-2