Comparative Analysis of Characteristics of Lower- and Mid-Cervical Spine Injuries in the Elderly

被引：0

作者：

Segi, Naoki ^{[1
]}

Nakashima, Hiroaki ^{[1
]}

Ito, Sadayuki ^{[1
]}

Ouchida, Jun ^{[1
]}

Yokogawa, Noriaki ^{[2
]}

Sasagawa, Takeshi ^{[2
,3
]}

Furuya, Takeo ^{[4
]}

Yunde, Atsushi ^{[4
]}

Funayama, Toru ^{[5
]}

Eto, Fumihiko ^{[6
]}

Watanabe, Kota ^{[7
]}

Nori, Satoshi ^{[7
]}

Ikegami, Shota ^{[8
]}

Uehara, Masashi ^{[8
]}

Hashimoto, Ko ^{[9
]}

Onoda, Yoshito ^{[9
]}

Nakajima, Hideaki ^{[10
]}

Suzuki, Hidenori ^{[11
]}

Imajo, Yasuaki ^{[11
]}

Yamada, Tomohiro ^{[12
,13
]}

Hasegawa, Tomohiko ^{[12
]}

Kawaguchi, Kenichi ^{[14
]}

Haruta, Yohei ^{[14
]}

Terashima, Yoshinori ^{[15
,16
]}

Hirota, Ryosuke ^{[15
]}

Tonomura, Hitoshi ^{[17
]}

Sakata, Munehiro ^{[17
,18
]}

Iizuka, Yoichi ^{[19
]}

Uei, Hiroshi ^{[20
,21
]}

Suzuki, Nobuyuki ^{[22
]}

Akeda, Koji ^{[23
]}

Tominaga, Hiroyuki ^{[24
]}

Seki, Shoji ^{[25
]}

Oshima, Yasushi ^{[26
]}

Kaito, Takashi ^{[27
]}

Otsuki, Bungo ^{[28
]}

Nakanishi, Kazuo ^{[29
]}

Kakutani, Kenichiro ^{[30
]}

Funao, Haruki ^{[31
,32
,33
,34
]}

Yoshii, Toshitaka ^{[35
]}

Sakai, Daisuke ^{[36
]}

Ohba, Tetsuro ^{[37
]}

Miyazaki, Masashi ^{[38
]}

Terai, Hidetomi ^{[39
]}

Inoue, Gen ^{[40
]}

Okada, Seiji ^{[27
]}

Imagama, Shiro ^{[1
]}

Kato, Satoshi ^{[2
]}

机构：

[1] Nagoya Univ, Grad Sch Med, Dept Orthoped Surg, Nagoya, Japan

[2] Kanazawa Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Kanazawa, Japan

[3] Toyama Prefectural Cent Hosp, Dept Orthopaed Surg, Toyama, Japan

[4] Chiba Univ, Grad Sch Med, Dept Orthopaed Surg, Chiba, Japan

[5] Univ Tsukuba, Fac Med, Dept Orthopaed Surg, Tsukuba, Japan

[6] Univ Tsukuba, Grad Sch Comprehens Human Sci, Dept Orthopaed Surg, Tsukuba, Japan

[7] Keio Univ, Sch Med, Dept Orthopaed Surg, Tokyo, Japan

[8] Shinshu Univ, Sch Med, Dept Orthopaed Surg, Matsumoto, Japan

[9] Tohoku Univ, Grad Sch Med, Dept Orthopaed Surg, Sendai, Japan

[10] Univ Fukui, Fac Med Sci, Fac Med Sci, Matsuoka Shimoaizuki, Yoshida, Japan

[11] Yamaguchi Univ, Dept Orthopaed Surg, Grad Sch Med, Ube, Japan

[12] Hamamatsu Univ Sch Med, Dept Orthopaed Surg, Hamamatsu, Japan

[13] Nagoya Kyoritsu Hosp, Dept Orthopaed Surg, Nagoya, Japan

[14] Kyushu Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Fukuoka, Japan

[15] Sapporo Med Univ, Dept Orthopaed Surg, Sapporo, Japan

[16] Matsuda Orthoped Mem Hosp, Dept Orthopaed Surg, Sapporo, Japan

[17] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Orthopaed, Kyoto, Japan

[18] Saiseikai Shiga Hosp, Dept Orthopaed, Ritto, Japan

[19] Gunma Univ, Grad Sch Med, Dept Orthopaed Surg, Maebashi, Japan

[20] Nihon Univ Hosp, Dept Orthopaed Surg, Tokyo, Japan

[21] Nihon Univ, Sch Med, Dept Orthopaed Surg, Tokyo, Japan

[22] Nagoya City Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Nagoya, Japan

[23] Mie Univ, Grad Sch Med, Dept Orthopaed Surg, Tsu, Japan

[24] Kagoshima Univ, Grad Sch Med & Dent Sci, Dept Orthopaed Surg, Kagoshima, Japan

[25] Univ Toyama, Fac Med, Dept Orthopaed Surg, Toyama, Japan

[26] Univ Tokyo Hosp, Dept Orthopaed Surg, Tokyo, Japan

[27] Osaka Univ, Grad Sch Med, Dept Orthopaed Surg, Suita, Osaka, Japan

[28] Kyoto Univ, Grad Sch Med, Dept Orthopaed Surg, Kyoto, Japan

[29] Kawasaki Med Sch, Dept Orthopaed Traumatol & Spine Surg, Kurashiki, Japan

[30] Kobe Univ, Grad Sch Med, Dept Orthopaed Surg, Kobe, Japan

[31] Int Univ Hlth & Welf, Sch Med, Dept Orthopaed Surg, Narita, Japan

[32] Int Univ Hlth & Welf, Narita Hosp, Dept Orthopaed Surg, Narita, Japan

[33] Int Univ Hlth & Welf, Mita Hosp, Dept Orthopaed Surg, Tokyo, Japan

[34] Int Univ Hlth & Welf, Mita Hosp, Spine & Spinal Cord Ctr, Tokyo, Japan

[35] Tokyo Med & Dent Univ, Dept Orthopaed Surg, Tokyo, Japan

[36] Tokai Univ, Dept Orthoped Surg, Surg Sci, Sch Med, Isehara, Japan

[37] Univ Yamanashi, Dept Orthopaed Surg, Chuo, Japan

[38] Oita Univ, Dept Orthopaed Surg, Fac Med, Yufu, Japan

[39] Osaka Metropolitan Univ, Grad Sch Med, Dept Orthopaed Surg, Osaka, Japan

[40] Kitasato Univ, Sch Med, Dept Orthopaed Surg, Sagamihara, Japan

来源：

SPINE SURGERY AND RELATED RESEARCH | 2024年 / 8卷 / 06期

关键词：

elderly; cervical spinal cord injury; lower-cervical injury; cervicothoracic injury; CORD INJURIES; TRAUMA; EPIDEMIOLOGY; DISLOCATIONS; FRACTURES; RISK; CT;

D O I：

10.22603/ssrr.2024-0030

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

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. Highenergy 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.

引用

页码：560 / 567

页数：8

共 29 条

[11] Cervical spine clearance in adults following blunt trauma: a national survey across major trauma centres in England
Chilvers, G.
Porter, K.
Choudhary, S.
[J]. CLINICAL RADIOLOGY, 2018, 73 (04) : 410.e1 - 410.e8
[12] Risk factors for deep vein thrombosis and pulmonary embolism -: A population-based case-control study
Heit, JA
Silverstein, MD
Mohr, DN
Petterson, TM
O'Fallon, WM
Melton, LJ
[J]. ARCHIVES OF INTERNAL MEDICINE, 2000, 160 (06) : 809 - 815
[13] Epidemiology of traumatic spinal cord injuries in Iceland from 1975 to 2009
Knutsdottir, S.
Thorisdottir, H.
Sigvaldason, K.
Jonsson, H., Jr.
Bjornsson, A.
Ingvarsson, P.
[J]. SPINAL CORD, 2012, 50 (02) : 123 - 126
[14] Lenoir Thibaut, 2006, Spine J, V6, P507, DOI 10.1016/j.spinee.2005.12.010
[15] Admission Prevalence and Risk Factors of Deep Vein Thrombosis in Patients with Spinal Cord Injury Complicated with Cervical Fractures
Lv, Bing
Wang, Haiying
Li, Weifeng
Han, Gefeng
Liu, Xiangdong
Zhang, Cheng
Zhang, Zipeng
[J]. CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS, 2022, 28
[16] Cervical disc degeneration is associated with a reduction in mobility: A cross-sectional study of 1211 asymptomatic healthy subjects
Machino, Masaaki
Nakashima, Hiroaki
Ito, Keigo
Ando, Kei
Ito, Sadayuki
Kato, Fumihiko
Imagama, Shiro
[J]. JOURNAL OF CLINICAL NEUROSCIENCE, 2022, 99 : 342 - 348
[17] MR T2 image classification in adult patients of cervical spinal cord injury without radiographic abnormality: A predictor of surgical outcome
Machino, Masaaki
Ando, Kei
Kobayashi, Kazuyoshi
Ota, Kyotaro
Morozumi, Masayoshi
Tanaka, Satoshi
Ito, Keigo
Kato, Fumihiko
Ishiguro, Naoki
Imagama, Shiro
[J]. CLINICAL NEUROLOGY AND NEUROSURGERY, 2019, 177 : 1 - 5
[18] Can Magnetic Resonance Imaging Reflect the Prognosis in Patients of Cervical Spinal Cord Injury Without Radiographic Abnormality?
Machino, Masaaki
Yukawa, Yasutsugu
Ito, Keigo
Nakashima, Hiroaki
Kanbara, Shunsuke
Morita, Daigo
Kato, Fumihiko
[J]. SPINE, 2011, 36 (24) : E1568 - E1572
[19] Spinal-cord injury
McDonald, JW
Sadowsky, C
[J]. LANCET, 2002, 359 (9304) : 417 - 425
[20] Venous thromboembolism in trauma: A local manifestation of systemic hypercoagulability?
Meissner, MH
Chandler, WL
Elliott, JS
[J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2003, 54 (02): : 224 - 231

← 1 2 3 →