Epidemiology of Cervical Fracture/Cervical Spinal Cord Injury and Changes in Surgical Treatment Modalities in Elderly Individuals During a 10-year Period: A Nationwide Multicenter Study in Japan

Abstract

Study Design Retrospective multicenter study Objectives To investigate changes over a 10-years period in the profile of cervical spine and spinal cord injuries among the elderly in Japan. Methods The current multicenter study was a retrospective analysis of inpatients aged ≥65 years, suffering cervical fracture (CF) and/or cervical spinal cord injury (CSCI). We analyzed 1413 patients’ epidemiology (from 2010 to 2019). Moreover, 727 patients who underwent surgical treatment were analyzed in 2 groups: the early (2010-2014) and late period (2015-2019). Results Both the number of patients and number of surgical patients showed a significant increasing trend ( P < .001), while the mean age, the distribution of injury levels and paralysis severity, and the proportion of surgical indications remained the same. The number of surgical patients doubled from 228 to 499 from the early to late periods. Posterior surgery was the most common approach (90.4%), instrumentation surgery with screws increased significantly, and the range of fusion was significantly longer in the late period (2.1 vs 2.7 levels, P = .001). Significantly worsening neurological symptoms were recorded in the late period (1.3% vs 5.8%, P = .006), with C5 palsy being the major one. Otherwise, perioperative, major, and other complications, including mortality, did not differ significantly in incidence. Conclusions Both the number of elderly CF and/or CSCI patients and number of patients undergoing surgery increased dramatically over the decade without any change in profile. Instrumentation surgeries with screws increased, without an increase in systemic complications.

Secondary Dislocations in Type B and C Injuries of the Subaxial Cervical Spine: Risk Factors and Treatment

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Low Nutrition before Injury Is a Risk Factor for Dysphagia in Older Patients with Cervical Spinal Cord Injury: Based on a Multicenter Data of 707 Patients

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Comparability of Elezanumab Safety, Tolerability, and Pharmacokinetics in Healthy Japanese, Chinese, and White Participants

“…The health burden of spinal cord injury (SCI) and ischemic stroke remains high and will likely increase as global populations, including East Asia, continue to age. [1][2][3][4] China, which has one of the largest populations of the world, is expected to have approximately 24%-27% of its population become 65 years old or older by 2050. 5 In addition to the increased risk of SCI from falls 3,6 and stroke 7 associated with advancing age, China is experiencing rapid industrialization and urbanization expansion, which brings higher risk for injury.…”

“…[1][2][3][4] China, which has one of the largest populations of the world, is expected to have approximately 24%-27% of its population become 65 years old or older by 2050. 5 In addition to the increased risk of SCI from falls 3,6 and stroke 7 associated with advancing age, China is experiencing rapid industrialization and urbanization expansion, which brings higher risk for injury. 2 As one of the world's fastest developing nations, China has the largest prevalence of SCI.…”

“…The health burden of spinal cord injury (SCI) and ischemic stroke remains high and will likely increase as global populations, including East Asia, continue to age 1‐4 . China, which has one of the largest populations of the world, is expected to have approximately 24%‐27% of its population become 65 years old or older by 2050 5 .…”