Prognostic Factors for Cervical Spinal Cord Injury without Major Bone Injury in Elderly Patients

Nakajima, Hideaki; Yokogawa, Noriaki; Sasagawa, Takeshi; Ando, Kei; Segi, Naoki; Watanabe, Kota; Nori, Satoshi; Watanabe, Shuji; Honjoh, Kazuya; Funayama, Toru; Eto, Fumihiko; Terashima, Yoshiaki; Hirota, Ryosuke; Furuya, Takeo; Yamada, Tomohiro; Inoue, Gen; Kaito, Takashi; Kato, Satoshi

doi:10.1089/neu.2021.0351

Cited by 17 publications

(14 citation statements)

References 31 publications

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“…vs. 44.2%, p<0.001) than those in the non-OPLL group [14] (Table5). Before matching, patients in the OPLL group displayed a lower baseline AIS grade (p=0.032) and baseline AMS (58.2±32.8 vs. 65.2±29.2, p=0.009) than those in the non-OPLL group [15] . There were no signi cant differences in the in-hospital complications and mortality between the groups (28.0% vs. 22.9%, p=0.166; 2.4% vs. 2.0%, p=0.770) (Table 6).…”

Section: Resultsmentioning

confidence: 93%

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Characteristics of the cervical spine and cervical cord injuries in the elderly with cervical ossification of the posterior longitudinal ligament

Okuwaki

Funayama

Koda

et al. 2022

Preprint

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Ossification of the posterior longitudinal ligament (OPLL) can be complicated cervical spinal cord injury (CSCI) by low energy trauma, which is increasing among the elderly and potentially life-threatening. However, the etiology and neurological outcome of CSCI with OPLL in the elderly remain unknown. Therefore, we conducted this multi-center retrospective cohort study, which identified 1,512 patients aged ≥ 65 years and diagnosed with CSCI on admission from 2010 to 2020. We analyzed the etiology in patients with OPLL. Moreover, we performed propensity score-adjusted analyses to compare the neurological outcomes between patients with and without OPLL. The primary outcome comprised the American Spine Injury Association (ASIA) impairment scale (AIS) grade and ASIA motor score (AMS). In 332 patients with OPLL, the men:women ratio was approximately 4:1. Half of all patients displayed low energy trauma-induced injury, and one-third of the patients had CSCI without a bony injury. The propensity score matching created 279 pairs. There was no significant difference in the AIS grade and AMS between the patients with and without OPLL during hospitalization, 6 months, and 12 months following injury. In summary, OPLL was not associated with neurological recovery in the elderly with CSCI.

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Section: Resultsmentioning

confidence: 93%

“…3352-1) and each center. The current study is a report presentation collected from the similar data as other studies [14,15] .…”

Section: Methodsmentioning

confidence: 93%

Characteristics of the cervical spine and cervical cord injuries in the elderly with cervical ossification of the posterior longitudinal ligament

Okuwaki

Funayama

Koda

et al. 2022

Preprint

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“…Patients in the OPLL group demonstrated younger age (74.4 ± 6.6 vs. 75.9 ± 6.7, p = 0.008), higher men-to-women ratio (78.7% vs. 68.2%, p = 0.006), higher BMI (22.8 ± 4.2 vs. 22.0 ± 4.0, p = 0.020), higher rate of smoking history (39.8% vs. 27.1%, p = 0.001), and a higher proportion of surgical treatment (61.6% vs. 44.2%, p < 0.001) than those in the non-OPLL group 14 (Table 5 ). Patients in the OPLL group displayed a lower baseline AIS grade (p = 0.032) and baseline AMS (58.2 ± 32.8 vs. 65.2 ± 29.2, p = 0.009) than those in the non-OPLL group before matching 15 . There were no significant differences in the in-hospital complications and mortality between the groups (28.0% vs. 22.9%, p = 0.166; 2.4% vs. 2.0%, p = 0.770) (Table 6 ).…”

Section: Resultsmentioning

confidence: 97%

“…3352-1) and each center approved the study protocol. The current study is a report presentation collected from similar data as other studies 14 , 15 and was conducted in compliance with the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

Characteristics of the cervical spine and cervical cord injuries in older adults with cervical ossification of the posterior longitudinal ligament

Okuwaki

Funayama

Koda

et al. 2023

Sci Rep

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Although the incidence of cervical spinal cord injury (CSCI) with ossification of the posterior longitudinal ligament (OPLL) has increased in older adults, its etiology and neurological outcomes remain unknown. We identified OPLL characteristics and determined whether they influence neurological severity and improvement of CSCI in older patients. This multicenter retrospective cohort study identified 1512 patients aged ≥ 65 years diagnosed with CSCI on admission during 2010–2020. We analyzed CSCI etiology in OPLL patients. We performed propensity score-adjusted analyses to compare neurological outcomes between patients with and without OPLL. Cases were matched based on variables influencing neurological prognosis. The primary neurological outcome was rated according to the American Spine Injury Association (ASIA) impairment scale (AIS) and ASIA motor score (AMS). In 332 OPLL patients, the male-to-female ratio was approximately 4:1. Half of all patients displayed low-energy trauma-induced injury and one-third had CSCI without a bony injury. Propensity score matching created 279 pairs. There was no significant difference in the AIS grade and AMS between patients with and without OPLL during hospitalization, 6 months, and 12 months following injury. OPLL patients tended to exhibit worse neurological findings during injury; nevertheless, OPLL was not associated with poor neurological improvement in older CSCI patients.

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“…This study analyzed multi-center registry data retrospectively collected by the Japan Association of Spine Surgeons with Ambition (JASA) [ 16 ]. Registrars reviewed the medical records and retrospectively registered cases into the JASA database based on the following inclusion and exclusion criteria: Inclusion criteria: patients aged ≥65 years with traumatic cervical SCI and/or traumatic cervical fracture; patients treated conservatively or surgically between 2010 and 2020 at an institution registered in the JASA and those who were followed for at least three months after the injury; Exclusion criteria: patients with cervical metastasis; and those with any missing data; Registrars did not exclude patients on the basis of specific medications, surgical procedures, surgical instruments, and/or reasons other than the inclusion/exclusion criteria indicated above.…”

Section: Methodsmentioning

confidence: 99%

Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture

Tamai¹,

Terai²,

Nakamura³

et al. 2023

JCM

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The number of elderly patients with cervical trauma is increasing. Such patients are considered to be at high risk for delirium, which is an acute neuropsychological disorder that reduces the patient’s capacity to interact with their environment due to impairments in cognition. This study aimed to establish a risk score that predicts delirium in elderly patients with cervical SCI and/or cervical fracture regardless of treatment type. This retrospective cohort study included 1512 patients aged ≥65 years with cervical SCI and/or cervical fracture. The risk factors for delirium according to treatment type (surgical or conservative) were calculated using multivariate logistic regression. A delirium risk score was established as the simple arithmetic sum of points assigned to variables that were significant in the multivariate analyses. Based on the statistical results, the delirium risk score was defined using six factors: old age (≥80 years), hypoalbuminemia, cervical fracture, major organ injury, dependence on pre-injury mobility, and comorbid diabetes. The score’s area under the curve for the prediction of delirium was 0.66 (p < 0.001). Although the current scoring system must be validated with an independent dataset, the system remains beneficial because it can be used after screening examinations upon hospitalization and before deciding the treatment strategy.

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Prognostic Factors for Cervical Spinal Cord Injury without Major Bone Injury in Elderly Patients

Cited by 17 publications

References 31 publications

Characteristics of the cervical spine and cervical cord injuries in the elderly with cervical ossification of the posterior longitudinal ligament

Characteristics of the cervical spine and cervical cord injuries in the elderly with cervical ossification of the posterior longitudinal ligament

Characteristics of the cervical spine and cervical cord injuries in older adults with cervical ossification of the posterior longitudinal ligament

Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture

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