Spine Surgery and Related Research最新文献

{"title":"Posterior Instrumentation without Curettage Promotes Rapid Restoration of Adult Spinal Langerhans Cell Histiocytosis.","authors":"Bungo Otsuki, Hiroaki Kimura, Shunsuke Fujibayashi, Takayoshi Shimizu, Takashi Sono, Koichi Murata, Shuichi Matsuda","doi":"10.22603/ssrr.2024-0040","DOIUrl":"10.22603/ssrr.2024-0040","url":null,"abstract":"<p><strong>Introduction: </strong>Adult spinal Langerhans cell histiocytosis (LCH) presents a treatment challenge due to ongoing controversies. Traditional approaches such as curettage with bone grafting and internal fixation are preferred for severe cases involving mechanical instability, neurological deficits, or deformity. This study aimed to explore the efficacy of a customized approach involving simple posterior instrumentation without curettage or bone grafting in treating adult spinal LCH.</p><p><strong>Methods: </strong>This retrospective study analyzed a prospectively maintained database of all spine surgeries conducted at our institute from April 2013 to December 2020. Adult patients (age≥20) diagnosed with LCH were included. We assessed surgical methods, adjuvant therapy, and clinical results, such as perioperative progression of disease, symptoms, and recurrence.</p><p><strong>Results: </strong>Four male patients aged between 21 and 28, each with a single spinal LCH lesion (T6, T5, and C5) except one case (T5 and T7), were treated. Diagnoses were confirmed via biopsy (two open, two needle biopsies). Whole-body computed tomography or bone scintigraphy revealed no additional LCH lesions in any patient, except in one patient with a small lung nodule. All patients presented with severe back or neck pain and pathological fractures at the affected vertebra. Thoracic LCH cases received percutaneous pedicle screw fixation, while the cervical case was managed with conventional posterior instrumentation using lateral mass screws. After surgery, all patients experienced significant pain relief, halted bone lysis, and rapid new bone formation. One patient underwent chemotherapy postsurgery. Over 3 years of follow-up, imaging studies revealed no recurrences of the disease.</p><p><strong>Conclusions: </strong>Posterior instrumentation, without the need for curettage or bone grafting, is a promising surgical treatment for adult spinal LCH. This method may effectively halt lesion progression, prevent spinal deformity, and avert neurological deficits in the patients with progressive spine lesion where conservative treatment may not adequately prevent vertebral fractures.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 6","pages":"637-643"},"PeriodicalIF":1.2,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervertebral Disc Degeneration in Long-Term Postoperative Patients with Adolescent Idiopathic Scoliosis: MRI Evaluation 34-51 Years after Surgery and its Changes during Middle and Older Age for an Average of 6.9 Years.","authors":"Tsutomu Akazawa, Toshiaki Kotani, Tsuyoshi Sakuma, Yasushi Iijima, Yoshiaki Torii, Jun Ueno, Atsuhiro Yoshida, Ken Tomochika, Sumihisa Orita, Yawara Eguchi, Kazuhide Inage, Yasuhiro Shiga, Junichi Nakamura, Yusuke Matsuura, Takane Suzuki, Hisateru Niki, Seiji Ohtori, Shohei Minami","doi":"10.22603/ssrr.2024-0043","DOIUrl":"10.22603/ssrr.2024-0043","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to identify factors associated with intervertebral disc degeneration (DD) in adolescent idiopathic scoliosis (AIS) patients who reached middle and older age after surgery.</p><p><strong>Methods: </strong>A total of 252 AIS patients who underwent spinal fusion surgery between 1968 and 1988 were included in this survey-based study. Patients with a mean follow-up period of 40.9 years were evaluated through lumbar spine magnetic resonance imaging (MRI), radiographic assessments, and patient-reported outcome measures (PROMs). DD was evaluated using the Pfirrmann grading system. Various factors, such as surgical levels, sagittal alignment, and PROMs, were analyzed for their association with DD.</p><p><strong>Results: </strong>Among the 21 participants who underwent both previous (conducted from 2014 to 2016) and latest surveys (conducted in 2022), the prevalence of DD increased from 66.7% in the previous survey to 76.9% in the latest survey. The overall Pfirrmann disc score significantly increased from 3.2 to 3.5. Sagittal alignment parameters, such as sagittal vertical axis (SVA), pelvic incidence minus lumbar lordosis (PI-LL), and pelvic tilt (PT), worsened over time. Scores in the Scoliosis Research Society-22 Questionnaire pain, Roland-Morris Disability Questionnaire, and Oswestry Disability Index were significantly worse in the latest survey than in the previous one. Comparison between patients with the lower instrumented vertebra (LIV) at L4 or lower and L3 or higher revealed significantly higher disc scores and 100% prevalence of DD in the L4 or lower group. Factors associated with DD included LIV at L4 or lower, smaller LL, larger thoracolumbar kyphosis, and increased SVA, PI-LL, and PT.</p><p><strong>Conclusions: </strong>This study suggests that maintaining the LIV at L3 or higher, achieving good sagittal alignment, and maintaining LL may help prevent long-term DD in AIS patients.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 1","pages":"61-70"},"PeriodicalIF":1.2,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Results of Our Protocol for Standardization of Perioperative Antiplatelet Agent Management on the Incidence of Epidural Hematoma and Thrombotic Complications in Posterior Cervical Surgery: A Prospective Cohort Study.","authors":"Gentaro Kumagai, Kanichiro Wada, Toru Asari, Yoshiro Nitobe, Kotaro Aburakawa, Yasuyuki Ishibashi","doi":"10.22603/ssrr.2024-0017","DOIUrl":"10.22603/ssrr.2024-0017","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to standardize perioperative interruption of antiplatelet agents in patients undergoing cervical spinal surgery and investigate the incidence of epidural hematoma and thrombotic complications.</p><p><strong>Methods: </strong>A total of 153 patients, consisting of 85 men and 68 women, were included in this study. Their mean age was 65.5 years. They were divided into two groups: Groups A and B. Group A (139 patients) did not receive preoperative antiplatelet agents, and Group B (14 patients) resumed antiplatelet agents from 7 or 14 days presurgery to 3 days postsurgery. Our analysis encompassed demographic data before surgery, postoperative magnetic resonance image-based assessment of radiological epidural hematoma (EH), and complications such as symptomatic hematoma, blood transfusion, stroke, and venous thromboembolism after surgery.</p><p><strong>Results: </strong>The frequency of medical conditions, such as hypertension, diabetes, and hyperlipidemia, was significantly higher in Group B than in Group A. The CHADS2 scores, which serve as a clinical prediction rule for estimating stroke risk, were significantly higher in Group B than in Group A. In contrast, the intraoperative blood loss was significantly lower in Group B than in Group A. There was no significant difference in radiologically severe EH, hemorrhage, and thrombotic complications between the two groups. Interestingly, none of the patients in Group B had hemorrhagic and thrombotic complications.</p><p><strong>Conclusions: </strong>Our standardized perioperative management of antiplatelet agents did not affect the incidence of radiological EH, hemorrhage, and thrombotic complications in patients undergoing cervical spinal surgery.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 6","pages":"568-574"},"PeriodicalIF":1.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sclerotherapy for Aggressive Vertebral Hemangioma with Severe Bone Destruction: A 5-Year Analysis.","authors":"Chikako Takeda, Shinji Tanishima, Yasufumi Ohuchi, Tokumitsu Mihara, Kensaku Yamaga, Masaki Yoshida, Hideki Nagashima","doi":"10.22603/ssrr.2024-0023","DOIUrl":"https://doi.org/10.22603/ssrr.2024-0023","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 5","pages":"548-551"},"PeriodicalIF":1.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Disc Degeneration between Pyogenic Spondylitis and Noninfected Lumbar Spondylosis: A Multicenter Retrospective Study with Propensity Score Matching.","authors":"Hisanori Gamada, Toru Funayama, Takane Nakagawa, Takahiro Sunami, Kotaro Sakashita, Kento Inomata, Shun Okuwaki, Tomoyuki Asada, Yosuke Shibao, Kousei Miura, Hiroshi Noguchi, Hiroshi Takahashi, Itsuo Shiina, Tsukasa Nakagawa, Masashi Yamazaki, Masao Koda","doi":"10.22603/ssrr.2024-0032","DOIUrl":"10.22603/ssrr.2024-0032","url":null,"abstract":"<p><strong>Introduction: </strong>Disc degeneration is a risk factor of pyogenic spondylitis. However, its degree in patients with pyogenic spondylitis is unknown. This study aimed to determine differences in disc degeneration between patients with pyogenic spondylitis and those with noninfectious lumbar spondylosis.</p><p><strong>Methods: </strong>A total of 85 patients with lumbar pyogenic spondylitis (the infected group) and 156 with lumbar spondylosis who underwent posterior lumbar interbody fusion (the noninfected group) were retrospectively evaluated. Patients with a previous history of spinal fusion, tuberculous spondylitis, and multilevel infection and those receiving dialysis were excluded. Magnetic resonance imaging of the lumbar spine was conducted. Each disc at the L1/2-L5/S levels was graded. The total score of the four discs, excluding the affected disc, was used as the modified disc degenerative disease (DDD) score. Propensity score matching was performed using independent variables such as age, sex, diabetes mellitus, cancer, and steroid use. The modified DDD scores at all and each disc level were compared between the two matched groups.</p><p><strong>Results: </strong>After matching, 48 patients in the infected group and 88 in the noninfected group were finally included in the study. The mean modified DDD scores of the infected and noninfected groups were 7.63 and 5.40, respectively. The modified DDD scores at all and each disc level were higher in the infected group than in the noninfected group.</p><p><strong>Conclusions: </strong>The incidence of disc degeneration at all and each disc level was higher in patients with pyogenic spondylitis than in those with noninfectious lumbar spondylosis.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 6","pages":"616-622"},"PeriodicalIF":1.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect Decompression in Vertebral Reconstruction for Osteoporotic Vertebral Fractures with Neurological Symptoms: A Preliminary Case Series.","authors":"Yoshinori Morita, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Jun Ouchida, Ryotaro Oishi, Ippei Yamauchi, Yuichi Miyairi, Mikito Tsushima, Kenyu Ito, Hiroyuki Tomita, Kazuaki Morishita, Tokumi Kanemura, Shiro Imagama","doi":"10.22603/ssrr.2024-0013","DOIUrl":"10.22603/ssrr.2024-0013","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the clinical and radiological outcome of \"indirect decompression\" using lateral-posterior combined surgery for osteoporotic vertebral fracture (OVF) with neurological symptoms.</p><p><strong>Methods: </strong>A total of 17 patients who underwent lateral and posterior combined indirect decompressive spinal reconstruction (LP-IDR) for single-level OVF with neurological symptoms were included in this study. The neurological symptoms (sensory disturbance and muscle weakness) and imaging findings (local angle and height of the fracture segment and bone fragment occupancy in the spinal canal) were investigated preoperatively, postoperatively, and at the 1-year follow-up.</p><p><strong>Results: </strong>Muscle weakness was observed preoperatively in ten patients. Nine patients had complete recovery of muscle weakness (<i>p</i><0.001), whereas one had residual muscle weakness at the 1-year follow-up. The presence of sensory disturbance was observed in 16 patients preoperatively, and it was significantly reduced to 8 patients at the 1-year follow-up (<i>p</i>=0.003). The bony fragment occupancy rate in the spinal canal was decreased from 44.0% to 40.2% postoperatively (<i>p</i>=0.04) and to 33.1% at 1 year (<i>p</i>=0.002). The local angle was corrected from 8.3° to -2.6° postoperatively (<i>p</i>=0.003) and to 1.2° at 1 year. The local height was corrected from 26.7 to 32.0 mm postoperatively (<i>p</i><0.001) and to 29.8 mm at 1 year.</p><p><strong>Conclusions: </strong>LP-IDR for OVF with neurological symptoms provided sufficient neurological improvement with expansion of the spinal canal over time.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 6","pages":"623-630"},"PeriodicalIF":1.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Intraoperative Blood Loss Volume in Elderly Cervical Spine Injury Surgery Greater in Patients with Ankylosis? A Multicenter Survey.","authors":"Masashi Uehara, Shota Ikegami, Takashi Takizawa, Hiroki Oba, Noriaki Yokogawa, Takeshi Sasagawa, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Kota Watanabe, Satoshi Nori, Kazuki Takeda, Takeo Furuya, Atsushi Yunde, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Yoshinori Terashima, Ryosuke Hirota, Hidenori Suzuki, Yasuaki Imajo, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Kenichi Kawaguchi, Yohei Haruta, Nobuyuki Suzuki, Kenji Kato, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Kosuke Misaki, Hidetomi Terai, Koji Tamai, Akiyoshi Kuroda, Gen Inoue, Kenichiro Kakutani, Yuji Kakiuchi, Katsuhito Kiyasu, Hiroyuki Tominaga, Hiroto Tokumoto, Yoichi Iizuka, Eiji Takasawa, Koji Akeda, Norihiko Takegami, Haruki Funao, Yasushi Oshima, Takashi Kaito, Daisuke Sakai, Toshitaka Yoshii, Tetsuro Ohba, Bungo Otsuki, Shoji Seki, Masashi Miyazaki, Masayuki Ishihara, Seiji Okada, Shiro Imagama, Satoshi Kato","doi":"10.22603/ssrr.2023-0118","DOIUrl":"10.22603/ssrr.2023-0118","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury.</p><p><strong>Methods: </strong>The case histories of 1512 patients with cervical spine injury at among 33 institutions were reviewed. After the exclusion of patients without surgery or whose blood loss or ankylosis status was unclear, 793 participants were available for analysis. Differences in blood loss volume were compared between the Ankylosis (+) group with ankylosis at the cervical level and the Ankylosis (-) group without by the inverse probability of treatment weighting (IPTW) method using a propensity score.</p><p><strong>Results: </strong>Of the 779 patients (mean age: 75.0±6.3 years) eligible for IPTW calculation, 257 (32.4%) had ankylosis at the cervical level. The mean blood loss volume was higher in Ankylosis (+) patients than in Ankylosis (-) patients (P<0.001). This difference did not reach statistical significance when weighted by background factors, with mean blood loss of 244 mL and 188 mL, respectively, after adjustment.</p><p><strong>Conclusions: </strong>This study revealed that ankylosis was significantly associated with increased blood loss volume when unadjusted by surgical time. Elderly patients with cervical spine injury accompanied by ankylosis appear predisposed to higher bleeding and severe hemorrhage, both as a result of the condition and their particular demographic characteristics.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 6","pages":"575-582"},"PeriodicalIF":1.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment for Cervical Lamina Metastasis from Parathyroid Carcinoma: A Case Report.","authors":"Masahiro Matsuda, Narihito Nagoshi, Mariko Sekimizu, Hajime Okita, Toshiki Okubo, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Osahiko Tsuji, Kota Watanabe, Masaya Nakamura","doi":"10.22603/ssrr.2023-0320","DOIUrl":"https://doi.org/10.22603/ssrr.2023-0320","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 5","pages":"544-547"},"PeriodicalIF":1.2,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concave Side Apical Control in Early Onset Scoliosis Managed with Growing Rods.","authors":"Tameem Mohammed Elkhateeb, Mohamed Wafa, Mahmoud Ahmed Ashour","doi":"10.22603/ssrr.2023-0317","DOIUrl":"10.22603/ssrr.2023-0317","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate curve correctability, complications, and rate of growth following treatment.</p><p><strong>Background: </strong>Distraction-founded techniques such as traditionally growing rods or magnetically controlled growing rods are the almost globally accepted management patterns for early onset scoliosis. However, periodic lengthening operations are still needed. Moreover, an MCGR is difficult to contour, and implant-associated problems are common. We developed concave side apical control of the growing rod in which an additional anchor site is inserted at the apex to enhance stability and assist in the adjustment of axial deformity.</p><p><strong>Methods: </strong>Entirely skeletally immature early onset scoliosis (EOS) cases with a progressive curve of >40° and without bone or soft tissue weakness were appropriate for this study. Coronal Cobb angle, sagittal parameters, complications, spinal length, and reoperations were documented with at least a 3-year follow-up.</p><p><strong>Results: </strong>In this study, 15 patients were involved. The mean age was 7 years. The mean preoperative Cobb angle was 48°, which postoperatively became 12° with the percentage of coronal correction reaching 75.73%. The mean Cobb angle degrees of correction were 39°. T1-S1 height increased by 10 mm/year. Postoperative complications occurred in two cases with single rod technique and rod breakage.</p><p><strong>Conclusions: </strong>The concave side apical control of the growing rod seems to be a hopeful surgical procedure for the management of EOS. Curve correctability in patients was 60% and can be sustained for a minimum of 2 years. Reoperations and complications might not be constricted, but the complication frequency looks more reasonable than in the current systems.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"8 6","pages":"608-615"},"PeriodicalIF":1.2,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"10.22603/ssrr.2024-0030","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":1.2,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}