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

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