Risk factors for delayed diagnosis of spinal fracture associated with diffuse idiopathic skeletal hyperostosis: A nationwide multiinstitution survey

被引：1

作者：

Kobayashi, Kazuyoshi ^{[1
,2
]}

Okada, Eijiro ^{[2
,3
]}

Yoshii, Toshitaka ^{[2
,4
]}

Tsushima, Mikito ^{[2
,5
]}

Yamada, Tsuyoshi ^{[2
,4
]}

Watanabe, Kei ^{[2
,6
]}

Katsumi, Keiichi ^{[2
,6
]}

Hiyama, Akihiko ^{[2
,7
]}

Katoh, Hiroyuki ^{[2
,7
]}

Watanabe, Masahiko ^{[2
,7
]}

Nakagawa, Yukihiro ^{[2
,8
]}

Okada, Motohiro ^{[2
,9
]}

Endo, Teruaki ^{[2
,10
]}

Shiraishi, Yasuyuki ^{[2
,10
]}

Takeuchi, Kazuhiro ^{[2
,11
]}

Matsunaga, Shunji ^{[2
,12
]}

Maruo, Keishi ^{[2
,13
]}

Sakai, Kenichiro ^{[2
,14
]}

Kobayashi, Sho ^{[2
,15
]}

Ohba, Tetsuro ^{[2
,16
]}

Wada, Kanichiro ^{[2
,17
]}

Ohya, Junichi ^{[2
,18
]}

Mori, Kanji ^{[2
,19
]}

Nishimura, Hirosuke ^{[2
,20
]}

Tsuji, Takashi ^{[2
,21
]}

Watanabe, Kota ^{[2
,3
]}

Okawa, Atsushi ^{[2
,4
]}

Matsumoto, Morio ^{[2
,3
]}

Imagama, Shiro ^{[1
,2
]}

机构：

[1] Nagoya Univ, Grad Sch Med, Dept Orthopaed Surg, Showa Ku, 65 Tsurumai Cho, Nagoya, Aichi 4668550, Japan

[2] Japanese Org Study Ossificat Spinal Ligament JOSL, Bunkyo Ku, 1-5-45 Yushima, Tokyo 1138519, Japan

[3] Keio Univ, Sch Med, Dept Orthopaed Surg, Shinjuku Ku, 35 Shinanomachi, Tokyo 1608582, Japan

[4] Tokyo Med & Dent Univ, Dept Orthopaed Surg, Bunkyo Ku, 1-5-45 Yushima, Tokyo 1138519, Japan

[5] Chubu Rosai Hosp, Dept Orthopaed Surg, Minato Ku, 1-10-6 Komei, Nagoya, Aichi 4558530, Japan

[6] Niigata Univ, Med & Dent Gen Hosp, Dept Orthopaed Surg, Chuo Ku, 1-757 Asahimachidori, Niigata 9518510, Japan

[7] Tokai Univ, Sch Med, Dept Orthopaed Surg, Surg Sci, 143 Shimokasuya, Isehara, Kanagawa 2591193, Japan

[8] Wakayama Med Univ, Kihoku Hosp, Dept Orthopaed Surg, 219 Myoji,Katsuragi Cho, Wakayama 6497113, Japan

[9] Wakayama Med Univ, Dept Orthopaed Surg, 811-1 Kimiidera, Wakayama 6418509, Japan

[10] Jichi Med Univ, Dept Orthopaed Surg, 3311-1 Yakushiji, Shimotsuke, Tochigi 3290498, Japan

[11] Natl Hosp Org Okayama Med Ctr, Dept Orthopaed Surg, Kita Ward, 1711-1 Tamasu, Okayama 7011192, Japan

[12] Imakiire Gen Hosp, Dept Orthopaed Surg, 4-16 Shimotatsuocho, Kagoshima 8928502, Japan

[13] Hyogo Coll Med, Dept Orthoped Surg, 1-1 Mukogawacho, Nishinomiya, Hyogo 6638501, Japan

[14] Saiseikai Kawaguchi Gen Hosp, Dept Orthopaed Surg, 5 Chome 11-5 Nishikawaguchi, Kawaguchi, Saitama 3328558, Japan

[15] Hamamatsu Univ Sch Med, Dept Orthopaed Surg, Higashi Ward, 1 Chome 20-1 Handayama, Hamamatsu, Shizuoka 4328580, Japan

[16] Univ Yamanashi, Dept Orthopaed Surg, 1110 Shimokato, Chuo, Yamanashi 4093898, Japan

[17] Hirosaki Univ, Grad Sch Med, Dept Orthopaed Surg, 5 Zaifu Cho, Hirosaki, Aomori 0368562, Japan

[18] Univ Tokyo, Dept Orthopaed Surg, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1138655, Japan

[19] Shiga Univ Med Sci, Dept Orthopaed Surg, Seta Tsukinowa Cho, Otsu, Shiga 5202192, Japan

[20] Tokyo Med Univ, Dept Orthopaed Surg, Shinjuku Ku, 6-1-1 Shinjuku, Tokyo 1608402, Japan

[21] Tokyo Med Ctr, Dept Orthopaed Surg, Meguro Ku, 2-5-1 Higashigaoka, Tokyo 1528902, Japan

来源：

JOURNAL OF ORTHOPAEDIC SCIENCE | 2021年 / 26卷 / 06期

关键词：

POSTERIOR LONGITUDINAL LIGAMENT; ANKYLOSING HYPEROSTOSIS; THORACIC OSSIFICATION; FORESTIERS DISEASE; PREVALENCE; DISH; SPONDYLITIS; POPULATION; MORPHOLOGY;

D O I：

10.1016/j.jos.2020.10.019

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: Patients with DISH are susceptible to spinal fractures and subsequent neurological impairment, including after minor trauma. However, DISH is often asymptomatic and fractures may have minimal symptoms, which may lead to delayed diagnosis. The purpose of this study was to identify risk factors delayed diagnosis of spinal fractures in patients with diffuse idiopathic skeletal hyperostosis (DISH). Methods: The subjects were 285 patients with DISH surgically treated at 18 medical centers from 2005 2015. Cause of injury, imaging findings, neurological status at the times of injury and first hospital amination, and the time from injury to diagnosis were recorded. A delayed diagnosis was defined as that made >24 h after injury. Results: Main causes of injury were minor trauma due to a fall from a standing or sitting position (51%) and high-energy trauma due to a fall from a high place (29%) or a traffic accident (12%). Delayed diagnosis occurred in 115 patients (40%; 35 females, 80 males; mean age 76.0 +/- 10.4 years), while 170 (60%; 29 females, 141 males; mean age 74.6 +/- 12.8 years) had early diagnosis. Delayed group had a significantly higher rate of minor trauma (n = 73, 63% vs. n = 73, 43%), significantly more Frankel grade E (intact neurological status) cases at the time of injury (n = 79, 69% vs. n = 73, 43%), and greater deterioration of Frankel grade from injury to diagnosis (34% vs. 8%, p < 0.01). In multivariate analysis, a minor trauma fall (OR 2.08; P < 0.05) and Frankel grade E at the time of injury (OR 2.29; P < 0.01) were significantly associated with delayed diagnosis. Conclusion: In patients with DISH, it is important to keep in mind the possibility of spinal fracture, even in a situation in which patient sustained only minor trauma and shows no neurological deficit. This is because delayed diagnosis of spinal fracture can cause subsequent neurological deterioration. (c) 2020 Published by Elsevier B.V. on behalf of The Japanese Orthopaedic Association.

引用

页码：968 / 973

页数：6

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