{"title":"Comparative Analysis of Characteristics of Lower- and Mid-Cervical Spine Injuries in the Elderly.","authors":"Naoki Segi, Hiroaki Nakashima, Sadayuki Ito, Jun Ouchida, Noriaki Yokogawa, Takeshi Sasagawa, Takeo Furuya, Atsushi Yunde, Toru Funayama, Fumihiko Eto, Kota Watanabe, Satoshi Nori, Shota Ikegami, Masashi Uehara, Ko Hashimoto, Yoshito Onoda, Hideaki Nakajima, Hidenori Suzuki, Yasuaki Imajo, Tomohiro Yamada, Tomohiko Hasegawa, Kenichi Kawaguchi, Yohei Haruta, Yoshinori Terashima, Ryosuke Hirota, Hitoshi Tonomura, Munehiro Sakata, Yoichi Iizuka, Hiroshi Uei, Nobuyuki Suzuki, Koji Akeda, Hiroyuki Tominaga, Shoji Seki, Yasushi Oshima, Takashi Kaito, Bungo Otsuki, Kazuo Nakanishi, Kenichiro Kakutani, Haruki Funao, Toshitaka Yoshii, Daisuke Sakai, Tetsuro Ohba, Masashi Miyazaki, Hidetomi Terai, Gen Inoue, Seiji Okada, Shiro Imagama, Satoshi Kato","doi":"10.22603/ssrr.2024-0030","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Elderly patients have a higher frequency of upper cervical fractures caused by minor trauma; nevertheless, the clinical differences between mid- and lower-cervical (C6-C7) injuries are unclear. The aim of this study was to compare the epidemiology of lower- and mid-cervical injuries in the elderly.</p><p><strong>Methods: </strong>This multicenter, retrospective study included 451 patients aged 65 years or older who had mid- or lower-cervical fractures/dislocations. Patients' demographic and treatment data were examined and compared based on mid- and lower-cervical injuries.</p><p><strong>Results: </strong>There were 139 patients (31%) with lower-cervical injuries and 312 (69%) with mid-cervical injuries. High-energy trauma (60% vs. 47%, p=0.025) and dislocation (55% vs. 45%, p=0.054) were significantly experienced more often by elderly patients with lower-cervical injuries than by patients with mid-cervical injuries. Although the incidence of key muscle weakness at the C5 to T1 levels were all significantly lower in patients with lower-cervical injuries than those with mid-cervical injuries, impairments at C5 occurred in 49% of them, and at C6, in 65%. No significant differences were found in the rates of death, pneumonia, or tracheostomy requirements, and no significant differences existed in ambulation or ASIA impairment scale grade for patients after 6 months of treatment.</p><p><strong>Conclusions: </strong>Elderly patients with lower-cervical fractures/dislocations were injured by high-energy trauma significantly more often than patients with mid-cervical injuries. Furthermore, half of the patients with lower-cervical injuries had mid-cervical level neurological deficits with a relatively high rate of respiratory complications.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 6","pages":"560-567"},"PeriodicalIF":1.2000,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625708/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Surgery and Related Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22603/ssrr.2024-0030","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/27 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Elderly patients have a higher frequency of upper cervical fractures caused by minor trauma; nevertheless, the clinical differences between mid- and lower-cervical (C6-C7) injuries are unclear. The aim of this study was to compare the epidemiology of lower- and mid-cervical injuries in the elderly.
Methods: This multicenter, retrospective study included 451 patients aged 65 years or older who had mid- or lower-cervical fractures/dislocations. Patients' demographic and treatment data were examined and compared based on mid- and lower-cervical injuries.
Results: There were 139 patients (31%) with lower-cervical injuries and 312 (69%) with mid-cervical injuries. High-energy trauma (60% vs. 47%, p=0.025) and dislocation (55% vs. 45%, p=0.054) were significantly experienced more often by elderly patients with lower-cervical injuries than by patients with mid-cervical injuries. Although the incidence of key muscle weakness at the C5 to T1 levels were all significantly lower in patients with lower-cervical injuries than those with mid-cervical injuries, impairments at C5 occurred in 49% of them, and at C6, in 65%. No significant differences were found in the rates of death, pneumonia, or tracheostomy requirements, and no significant differences existed in ambulation or ASIA impairment scale grade for patients after 6 months of treatment.
Conclusions: Elderly patients with lower-cervical fractures/dislocations were injured by high-energy trauma significantly more often than patients with mid-cervical injuries. Furthermore, half of the patients with lower-cervical injuries had mid-cervical level neurological deficits with a relatively high rate of respiratory complications.