Clinical Analysis of Spinal Cord Injury With or Without Cervical Ossification of the Posterior Longitudinal Ligament, Spondylosis, and Canal Stenosis in Elderly Head Injury Patients

Nakae, Ryuta; Onda, Hidetaka; Yokobori, Shoji; Araki, Takashi; Fuse, Akira; Toda, Shigeki; Kushimoto, Shigeki; Teramoto, Akira

doi:10.2176/nmc.50.461

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…This is not a surprising finding, because a male predominance as high as 72% to 96% was also reported in other series (1,7,10,11,14). This is probably due to male dominance in both spinal cord injury and cervical canal stenosis, especially in OPLL.…”

Section: Discussionsupporting

confidence: 79%

Cervical spinal cord injury in patients with cervical canal stenosis without radiologic evidence of trauma: evaluation of 15 consecutive cases

Eren¹,

Tufan²,

Çetin³

et al. 2017

Bagcilar Medical Bulletin

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Objective: Cervical spinal canal stenosis is a well-known risk factor for spinal cord injury. In some patients, spinal cord injury is the first symptom of spinal stenosis. Therefore, some authors recommend preventive decompression of the spinal canal in asymptomatic patients with spinal stenosis. In this study, we aimed to determine the outcome of patients with spinal cord injury associated with cervical spinal canal stenosis and the rate of previously asymptomatic patients. Material and Methods: Data of 15 consecutive patients were evaluated. Improvement of neurological deficits during followup was accepted as good outcome and mortality and unchanging neurological deficits were accepted as worse outcome. Results: All patients were male, aged between 44 and 85 years. High-energy traumas caused injury in 7 of the cases and low-energy traumas in the others. Nine cases had central cord injury and 6 had other types of traumas. Only 2 patients had been diagnosed with minor symptoms associated with cervical canal stenosis before trauma, while the other patients had been asymptomatic. One patient did not consent to undergo an operation and two others could not be operated because of their general status; the latter 2 patients died. The other 12 patients were decompressed 0 to 40 days after trauma. Two other patients with severe transverse-type cord injury also died postoperatively. The other patients were followed for 1 to 48 months (22.7±17.7 months). In 2 patients, neurological deficits had not improved on last follow-up. Deficits had completely or partly improved in the other patients, including the one who had not accepted the operation. Central cord injury had a significantly better prognosis than other types (p=0.0019). Age, cervical canal diameter, and motor and sensory scores of the American Spinal Injury Association scale, type of trauma, and level of spinal cord injury were not significantly different in the patients with good and worse prognosis. Conclusion:The rate of asymptomatic patients before trauma was very high in patients with spinal cord injury associated with cervical spinal canal stenosis. Therefore, the treatment decision must be carefully assessed in asymptomatic cervical spinal stenosis patients. Catastrophic consequences of spinal trauma may be seen in patients with cervical spinal canal stenosis even in asymptomatic patients. Central cord syndrome had a good prognosis in these patients. Other types of injuries such as transverse and motor types had a worse outcome. Keywords: cervical spinal canal stenosis, spinal cord injuries, spinal cord trauma ÖZET Servikal dar kanal hastalarında radyolojik travma bulgusu olmaksızın servikal omurilik yaralanması: Ardışık 15 olgunun değerlendirilmesi Amaç: Servikal spinal dar kanal omurilik yaralanması için iyi bilinen bir risk faktörüdür. Bazı olgularda kanal darlığının ilk belirtisi omurilik yaralanması olabilir. Bu nedenle bazı yazarlar kanal darlığı olan belirtisiz olgularda önleyici amaçla dekompresyon önermektedir. Bu çalışmada servikal dar ka...

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Section: Discussionsupporting

confidence: 79%

Cervical spinal cord injury in patients with cervical canal stenosis without radiologic evidence of trauma: evaluation of 15 consecutive cases

Eren¹,

Tufan²,

Çetin³

et al. 2017

Bagcilar Medical Bulletin

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“…Degenerative changes are common in the cervical spine in older adults, leading to a reduction in the cervical spinal canal reserve gap. 17 Overextension of the cervical spine caused by low-energy trauma such as low fall can squeeze the spinal cord in the narrow spinal canal, resulting in edema, bleeding, and/or axonal degeneration in the central spinal cord. 18,19 Similar to previous research, most of the spinal cord injury segments caused by low falls were in C3-5, with the injury classified as Grade C or D. 20 Older adults contend with many subtle hazards because of their age; therefore, attention should be paid to implementing preventative measures for reducing the risk of injury.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological features of traumatic spinal cord injury in Beijing, China

Liu

Gao

et al. 2020

The Journal of Spinal Cord Medicine

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Objective: To describe epidemiological features of traumatic spinal cord injury (TSCI) and to conduct a comparison with data from 2002. Design: Retrospective research. Setting: China Rehabilitation Research Center (CRRC), Beijing. Methods: Five hundred and ninety patients with TSCI were admitted to the CRRC from 1st January 2011 to 31st December 2019. We collected data on sex, age, marital status, etiology, occupation, neurological level of injury, and the American Spinal Injury Association Impairment Scale on admission, time of injury and treatment. Results: Statistically significant differences were observed between data from 2002 and the present results (P < 0.001). The mean age of patients with TSCI was 46.3 ± 15.5 years, and the male/female ratio was 4.73:1. The incidence of TSCI increased gradually with age and peaked in the 40-49 age group. The most common occupation was worker (28.6%), followed by office clerk (16.8%) and retired (15.4%). Fall from heights (30.8%), followed by traffic accidents (27.6%) and low falls (25.1%), were the leading etiologies of TSCI. A majority of patients (54.9%) had cervical injuries, 91.9% underwent surgical treatment, and the lowest number of injuries were recorded during winter (19.6%). Conclusion: According to the changes in the epidemiological characteristics of TSCI, preventative strategies should be readjusted. We should pay more attention to the risk of low falls of the elderly. The authors recommend that stricter regulatory practices and safety measures should be developed alongside infrastructure improvements to reduce, and perhaps prevent TSCI.

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“…These conditions create vulnerabilities to CSI caused by low energy mechanisms, such as falls from standing height. [1415] In CSI patients who were age 65 or older, 21.4% had spondylosis and 16.7% had cervical canal stenosis, and falls were the cause of the CSI in 71.5% of these patients. [12]…”

Section: Introductionmentioning

confidence: 99%

Risk factors for cervical spine injury among patients with traumatic brain injury

Fujii

Faul

Sasser

2013

J Emerg Trauma Shock

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Background:Diagnosis of cervical spine injury (CSI) is difficult in patients with an altered level of consciousness as a result of a traumatic brain injury (TBI). Patients with TBI and older adults are at increased risk for CSI. This study examined the various risk factors for CSI among trauma patients with TBI and whether adults who were older (≥55 years) were at higher risk for CSI when they sustained a fall-related TBI.Materials and Methods:Data used was the 2007 National Trauma Data Bank (NTDB), National Sample Project (NSP) for adults who sustained a TBI. This dataset contains 2007 admission records from 82 level I and II trauma centers. Logistic regression was used to identify potential risk factors for CSI and to test for interaction between age and injury mechanism. Additional model variables included gender, race, Glasgow Coma Score, multiple severe injuries, hypotension and respiratory distress.Results:An analysis of the NTDB NSP identified 187,709 adults with TBI, of which 16,078 were diagnosed with a concomitant CSI. In motor vehicle traffic injuries, the older age group had significantly higher odds of CSI (odds ratio [OR] = 1.26 [1.15-1.39]). In fall-related injuries the older age group did not have a higher odds of CSI compared to the younger age group. Skull/face fracture, other spine fracture/dislocation, upper limb injury, thorax injury, and hypotension were significantly associated with CSI. Pelvic injuries had an inverse association with CSI (OR = 0.60 [0.54-0.67]). Black had significantly higher odds of CSI compared to Whites (OR = 1.25 [1.07-1.46]).Conclusion:The identification of associated injuries and factors may assist physicians in evaluating CSI in patients with TBI.

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Clinical Analysis of Spinal Cord Injury With or Without Cervical Ossification of the Posterior Longitudinal Ligament, Spondylosis, and Canal Stenosis in Elderly Head Injury Patients

Cited by 7 publications

References 14 publications

Cervical spinal cord injury in patients with cervical canal stenosis without radiologic evidence of trauma: evaluation of 15 consecutive cases

Cervical spinal cord injury in patients with cervical canal stenosis without radiologic evidence of trauma: evaluation of 15 consecutive cases

Epidemiological features of traumatic spinal cord injury in Beijing, China

Risk factors for cervical spine injury among patients with traumatic brain injury

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