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1. Association Between Early Surgery and Postoperative Opioid Use in Patients With Lumbar Disc Herniation: A Propensity Score-Matching Analysis Using an Administrative Claims Database in Japan.

Author

Honda, Akira, Iizuka, Yoichi, Tokue, Mieda, Takasawa, Eiji, Ishiwata, Sho, Tomomatsu, Yusuke, Ito, Shunsuke, Inomata, Kazuhiro, Okada, Akira, Matsui, Hiroki, Yasunaga, Hideo, and Chikuda, Hirotaka

Subjects
SPINAL surgery, DATABASES, HERNIA, OPIOIDS, SURGERY, DELAYED diagnosis
Abstract

Study Design: Retrospective cohort study Objectives: This study aimed to investigate whether early surgery shortens the duration of opioid use in patients who underwent surgery with lumbar disc herniation. Methods: We extracted patients who underwent surgery at least 2 weeks after they were diagnosed with lumbar disc herniation between April 2014 and May 2021. Opioid use after surgery was compared between patients who underwent surgery within 90 days (early surgery group) and 90 days or later (late surgery group). Propensity-score-matching analysis and multivariable Cox hazard regression analysis with a restricted cubic spline model were conducted to evaluate the association between the timing of surgery and termination of opioid use after surgery. Results: A total of 1597 eligible patients were identified, with 807 (51%) in the early surgery group. In the propensity-score-matched cohort, the early surgery group had a significantly lower proportion of opioid use than the control group (28% vs 48%, percent difference −20%, P <.001). Multivariable Cox hazard regression analysis showed that early surgery was significantly associated with the earlier termination of opioid use (HR, 3.13; 95% CI, 1.97-4.97; P <.001). Restricted cubic spline model showed a monotonically decreased hazard ratio and decreased hazard ratio of.50 in patients who underwent surgery 111 days or later after the diagnosis. Conclusions: Early surgery, especially within 90 days, was associated with earlier opioid use termination after surgery. Regarding the duration of opioid use following surgery, surgical treatment may be preferable to perform within around 4 months after the diagnosis. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Early Versus Delayed Surgery for Elderly Traumatic Cervical Spinal Injury: A Nationwide Multicenter Study in Japan

Author

Segi, Naoki, primary, Nakashima, Hiroaki, additional, Ito, Sadayuki, additional, Yokogawa, Noriaki, additional, Sasagawa, Takeshi, additional, Watanabe, Kota, additional, Nori, Satoshi, additional, Funayama, Toru, additional, Eto, Fumihiko, additional, Nakajima, Hideaki, additional, Terashima, Yoshinori, additional, Hirota, Ryosuke, additional, Hashimoto, Ko, additional, Onoda, Yoshito, additional, Furuya, Takeo, additional, Yunde, Atsushi, additional, Ikegami, Shota, additional, Uehara, Masashi, additional, Suzuki, Hidenori, additional, Imajo, Yasuaki, additional, Uei, Hiroshi, additional, Sawada, Hirokatsu, additional, Kawaguchi, Kenichi, additional, Nakanishi, Kazuo, additional, Suzuki, Nobuyuki, additional, Oshima, Yasushi, additional, Hasegawa, Tomohiko, additional, Iizuka, Yoichi, additional, Tonomura, Hitoshi, additional, Terai, Hidetomi, additional, Akeda, Koji, additional, Seki, Shoji, additional, Ishihara, Masayuki, additional, Inoue, Gen, additional, Funao, Haruki, additional, Yoshii, Toshitaka, additional, Kaito, Takashi, additional, Kiyasu, Katsuhito, additional, Tominaga, Hiroyuki, additional, Kakutani, Kenichiro, additional, Sakai, Daisuke, additional, Ohba, Tetsuro, additional, Otsuki, Bungo, additional, Miyazaki, Masashi, additional, Murotani, Kenta, additional, Okada, Seiji, additional, Imagama, Shiro, additional, and Kato, Satoshi, additional

Published
2024
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3. Epidemiology of Cervical Fracture/Cervical Spinal Cord Injury and Changes in Surgical Treatment Modalities in Elderly Individuals During a 10-year Period: A Nationwide Multicenter Study in Japan

Author

Segi, Naoki, Nakashima, Hiroaki, Machino, Masaaki, Ito, Sadayuki, Yokogawa, Noriaki, Sasagawa, Takeshi, Funayama, Toru, Eto, Fumihiko, Watanabe, Kota, Nori, Satoshi, Furuya, Takeo, Yunde, Atsushi, Nakajima, Hideaki, Hasegawa, Tomohiko, Yamada, Tomohiro, Terashima, Yoshinori, Hirota, Ryosuke, Suzuki, Hidenori, Imajo, Yasuaki, Ikegami, Shota, Uehara, Masashi, Tonomura, Hitoshi, Sakata, Munehiro, Hashimoto, Ko, Onoda, Yoshito, Kawaguchi, Kenichi, Haruta, Yohei, Suzuki, Nobuyuki, Kato, Kenji, Uei, Hiroshi, Sawada, Hirokatsu, Nakanishi, Kazuo, Misaki, Kosuke, Terai, Hidetomi, Tamai, Koji, Inoue, Gen, Shirasawa, Eiki, Kakutani, Kenichiro, Iizuka, Yoichi, Takasawa, Eiji, Akeda, Koji, Kiyasu, Katsuhito, Tominaga, Hiroyuki, Tokumoto, Hiroto, Funao, Haruki, Oshima, Yasushi, Yoshii, Toshitaka, Kaito, Takashi, Sakai, Daisuke, Ohba, Tetsuro, Seki, Shoji, Otsuki, Bungo, Ishihara, Masayuki, Miyazaki, Masashi, Okada, Seiji, Imagama, Shiro, and Kato, Satoshi

Abstract

Study Design Retrospective multicenter studyObjectives To investigate changes over a 10-years period in the profile of cervical spine and spinal cord injuries among the elderly in Japan.Methods The current multicenter study was a retrospective analysis of inpatients aged ≥65 years, suffering cervical fracture (CF) and/or cervical spinal cord injury (CSCI). We analyzed 1413 patients’ epidemiology (from 2010 to 2019). Moreover, 727 patients who underwent surgical treatment were analyzed in 2 groups: the early (2010-2014) and late period (2015-2019).Results Both the number of patients and number of surgical patients showed a significant increasing trend (P< .001), while the mean age, the distribution of injury levels and paralysis severity, and the proportion of surgical indications remained the same. The number of surgical patients doubled from 228 to 499 from the early to late periods. Posterior surgery was the most common approach (90.4%), instrumentation surgery with screws increased significantly, and the range of fusion was significantly longer in the late period (2.1 vs 2.7 levels, P= .001). Significantly worsening neurological symptoms were recorded in the late period (1.3% vs 5.8%, P= .006), with C5 palsy being the major one. Otherwise, perioperative, major, and other complications, including mortality, did not differ significantly in incidence.Conclusions Both the number of elderly CF and/or CSCI patients and number of patients undergoing surgery increased dramatically over the decade without any change in profile. Instrumentation surgeries with screws increased, without an increase in systemic complications.

Published
2024
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4. Effect of Intraoperative Tranexamic Acid on Perioperative Major Hemorrhage Requiring Transfusion in Patients Undergoing Elective Spine Surgery: A Propensity Score-Matched Analysis Using a National Inpatient Database.

Author

Honda, Akira, Iizuka, Yoichi, Michihata, Nobuaki, Uda, Kazuaki, Mieda, Tokue, Takasawa, Eiji, Ishiwata, Sho, Kakuta, Yohei, Tomomatsu, Yusuke, Ito, Shunsuke, Inomata, Kazuhiro, Matsui, Hiroki, Fushimi, Kiyohide, Yasunaga, Hideo, and Chikuda, Hirotaka

Subjects
SPINAL surgery, ELECTIVE surgery, BLOOD transfusion, TRANEXAMIC acid, DATABASES, ACUTE coronary syndrome
Abstract

Study Design: Retrospective cohort study. Objectives: This study aimed to examine whether the use of intravenous TXA in elective spine surgery is associated with reduced perioperative massive hemorrhage requiring transfusion. Methods: We extracted all patients who underwent decompression with or without fusion surgery for the cervical, thoracic, and lumbar spine between April 2012 and March 2019. The primary outcome was the occurrence of massive hemorrhage requiring transfusion, defined as at least 560 mL of blood transfusion within 2 days of spine surgery or the requirement of additional blood transfusion from 3-7 days postoperatively. Secondary outcomes were the occurrence of thrombotic complications (pulmonary embolism, acute coronary syndrome, and stroke) and postoperative hematoma requiring additional surgery. Results: We identified 83,821 eligible patients, with 9747 (12%) patients in the TXA group. Overall, massive hemorrhage requiring transfusion occurred in 781 (.9%) patients. Propensity score matching yielded 8394 pairs. In the matched cohort, the TXA group had a lower proportion of massive hemorrhage requiring transfusion than the control group (.7% vs 1.1%; P =.002). There was no significant difference in the occurrence of thrombotic complications and postoperative hematoma requiring additional surgery between both groups. The multivariable regression analysis also showed that the use of TXA was associated with significantly lower proportions of massive hemorrhage requiring transfusion (odds ratio,.62; 95% confidence interval,.43-.90; P =.012). Conclusions: In this analysis using real-world data, TXA use in elective spinal surgery was associated with reduced perioperative massive hemorrhage requiring transfusion without increasing thrombotic complications. Level of evidence: Prognostic Level Ⅲ [ABSTRACT FROM AUTHOR]

Published
2024
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5. Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey

Author

Hirota, Ryosuke, Terashima, Yoshinori, Ohnishi, Hirofumi, Yamashita, Toshihiko, Yokogawa, Noriaki, Sasagawa, Takeshi, Ando, Kei, Nakashima, Hiroaki, Segi, Naoki, Funayama, Toru, Eto, Fumihiko, Yamaji, Akihiro, Watanabe, Kota, Yamane, Junichi, Takeda, Kazuki, Furuya, Takeo, Yunde, Atsushi, Nakajima, Hideaki, Yamada, Tomohiro, Hasegawa, Tomohiko, Suzuki, Hidenori, Imajo, Yasuaki, Ikegami, Shota, Uehara, Masashi, Tonomura, Hitoshi, Sakata, Munehiro, Hashimoto, Ko, Onoda, Yoshito, Kawaguchi, Kenichi, Haruta, Yohei, Suzuki, Nobuyuki, Kato, Kenji, Uei, Hiroshi, Sawada, Hirokatsu, Nakanishi, Kazuo, Misaki, Kosuke, Terai, Hidetomi, Tamai, Koji, Shirasawa, Eiki, Inoue, Gen, Kakutani, Kenichiro, Kakiuchi, Yuji, Kiyasu, Katsuhito, Tominaga, Hiroyuki, Tokumoto, Hiroto, Iizuka, Yoichi, Takasawa, Eiji, Akeda, Koji, Takegami, Norihiko, Funao, Haruki, Oshima, Yasushi, Kaito, Takashi, Sakai, Daisuke, Yoshii, Toshitaka, Ohba, Tetsuro, Otsuki, Bungo, Seki, Shoji, Miyazaki, Masashi, Ishihara, Masayuki, Okada, Seiji, Imagama, Shiro, and Kato, Satoshi

Abstract

Study design Retrospective Cohort StudyObjective The purpose of this study was to investigate the prognosis of respiratory function in elderly patients with cervical spinal cord injury (SCI) and to identify predictive factors.Methods We included 1353 cases of elderly cervical SCI patients collected from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were defined as the respiratory disability group. Patients’ background characteristics, injury mechanism, injury form, neurological disability, complications, and treatment methods were compared between the disability and non-disability groups. Multiple logistic regression analysis was used to examine the independent factors. Patients who required respiratory management for 6 months or longer after injury and those who died of respiratory complications were classified into the severe disability group and were compared with minor cases who were weaned off the respirator.Results A total of 104 patients (7.8%) had impaired respiratory function. Comparisons between the disabled and non-disabled groups and between the severe and mild injury groups yielded distinct trends. In multiple logistic regression analysis, age, blood glucose level, presence of ossification of posterior longitudinal ligament (OPLL), anterior vertebral hematoma, and critical paralysis were selected as independent risk factors.Conclusion Age, OPLL, severe paralysis, anterior vertebral hematoma, hypoalbuminemia, and blood glucose level at the time of injury were independent factors for respiratory failure. Hyperglycemia may have a negative effect on respiratory function in this condition.

Published
2024
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6. Association Between Early Surgery and Postoperative Opioid Use in Patients With Lumbar Disc Herniation: A Propensity Score-Matching Analysis Using an Administrative Claims Database in Japan

Author

Honda, Akira, primary, Iizuka, Yoichi, additional, Tokue, Mieda, additional, Takasawa, Eiji, additional, Ishiwata, Sho, additional, Tomomatsu, Yusuke, additional, Ito, Shunsuke, additional, Inomata, Kazuhiro, additional, Okada, Akira, additional, Matsui, Hiroki, additional, Yasunaga, Hideo, additional, and Chikuda, Hirotaka, additional

Published
2023
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7. Epidemiology of Cervical Fracture/Cervical Spinal Cord Injury and Changes in Surgical Treatment Modalities in Elderly Individuals During a 10-year Period: A Nationwide Multicenter Study in Japan

Author

Segi, Naoki, primary, Nakashima, Hiroaki, additional, Machino, Masaaki, additional, Ito, Sadayuki, additional, Yokogawa, Noriaki, additional, Sasagawa, Takeshi, additional, Funayama, Toru, additional, Eto, Fumihiko, additional, Watanabe, Kota, additional, Nori, Satoshi, additional, Furuya, Takeo, additional, Yunde, Atsushi, additional, Nakajima, Hideaki, additional, Hasegawa, Tomohiko, additional, Yamada, Tomohiro, additional, Terashima, Yoshinori, additional, Hirota, Ryosuke, additional, Suzuki, Hidenori, additional, Imajo, Yasuaki, additional, Ikegami, Shota, additional, Uehara, Masashi, additional, Tonomura, Hitoshi, additional, Sakata, Munehiro, additional, Hashimoto, Ko, additional, Onoda, Yoshito, additional, Kawaguchi, Kenichi, additional, Haruta, Yohei, additional, Suzuki, Nobuyuki, additional, Kato, Kenji, additional, Uei, Hiroshi, additional, Sawada, Hirokatsu, additional, Nakanishi, Kazuo, additional, Misaki, Kosuke, additional, Terai, Hidetomi, additional, Tamai, Koji, additional, Inoue, Gen, additional, Shirasawa, Eiki, additional, Kakutani, Kenichiro, additional, Iizuka, Yoichi, additional, Takasawa, Eiji, additional, Akeda, Koji, additional, Kiyasu, Katsuhito, additional, Tominaga, Hiroyuki, additional, Tokumoto, Hiroto, additional, Funao, Haruki, additional, Oshima, Yasushi, additional, Yoshii, Toshitaka, additional, Kaito, Takashi, additional, Sakai, Daisuke, additional, Ohba, Tetsuro, additional, Seki, Shoji, additional, Otsuki, Bungo, additional, Ishihara, Masayuki, additional, Miyazaki, Masashi, additional, Okada, Seiji, additional, Imagama, Shiro, additional, and Kato, Satoshi, additional

Published
2023
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8. Prognostic Factors for Respiratory Dysfunction for Cervical Spinal Cord Injury and/or Cervical Fractures in Elderly Patients: A Multicenter Survey

Author

Hirota, Ryosuke, primary, Terashima, Yoshinori, additional, Ohnishi, Hirofumi, additional, Yamashita, Toshihiko, additional, Yokogawa, Noriaki, additional, Sasagawa, Takeshi, additional, Ando, Kei, additional, Nakashima, Hiroaki, additional, Segi, Naoki, additional, Funayama, Toru, additional, Eto, Fumihiko, additional, Yamaji, Akihiro, additional, Watanabe, Kota, additional, Yamane, Junichi, additional, Takeda, Kazuki, additional, Furuya, Takeo, additional, Yunde, Atsushi, additional, Nakajima, Hideaki, additional, Yamada, Tomohiro, additional, Hasegawa, Tomohiko, additional, Suzuki, Hidenori, additional, Imajo, Yasuaki, additional, Ikegami, Shota, additional, Uehara, Masashi, additional, Tonomura, Hitoshi, additional, Sakata, Munehiro, additional, Hashimoto, Ko, additional, Onoda, Yoshito, additional, Kawaguchi, Kenichi, additional, Haruta, Yohei, additional, Suzuki, Nobuyuki, additional, Kato, Kenji, additional, Uei, Hiroshi, additional, Sawada, Hirokatsu, additional, Nakanishi, Kazuo, additional, Misaki, Kosuke, additional, Terai, Hidetomi, additional, Tamai, Koji, additional, Shirasawa, Eiki, additional, Inoue, Gen, additional, Kakutani, Kenichiro, additional, Kakiuchi, Yuji, additional, Kiyasu, Katsuhito, additional, Tominaga, Hiroyuki, additional, Tokumoto, Hiroto, additional, Iizuka, Yoichi, additional, Takasawa, Eiji, additional, Akeda, Koji, additional, Takegami, Norihiko, additional, Funao, Haruki, additional, Oshima, Yasushi, additional, Kaito, Takashi, additional, Sakai, Daisuke, additional, Yoshii, Toshitaka, additional, Ohba, Tetsuro, additional, Otsuki, Bungo, additional, Seki, Shoji, additional, Miyazaki, Masashi, additional, Ishihara, Masayuki, additional, Okada, Seiji, additional, Imagama, Shiro, additional, and Kato, Satoshi, additional

Published
2022
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9. The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy.

Author

Ishiwata, Sho, Iizuka, Yoichi, Shitara, Hitoshi, Mieda, Tokue, Takasawa, Eiji, Tsunoda, Daisuke, Kakuta, Yohei, Honda, Akira, Ito, Shunsuke, Inomata, Kazuhiro, Sasaki, Tsuyoshi, Hamano, Noritaka, Tajika, Tsuyoshi, and Chikuda, Hirotaka

Abstract

Study Design: Case series study. Objective: We aimed to clarify the prevalence of rotator cuff tear (RCT), and the association between RCT and the severity and prognosis in patients with proximal type cervical spondylotic amyotrophy (CSA). Methods: We retrospectively analyzed 35 proximal type CSA patients who were treated conservatively. The following data was collected: age, rotator cuff status on MRI, manual muscle test (MMT) score of shoulder abductor and biceps brachii muscles both at the first visit and final follow-up. We investigated the prevalence of RCT and the association between the rotator cuff status, and the severity and recovery of upper extremity weakness in patients with proximal type CSA. Results: Of the 35 patients, 21 had an RCT on MRI, indicating that the prevalence of RCT in patients with proximal type CSA was 60%. An age-adjusted analysis showed that the presence of RCT was significantly associated with the MMT score of the shoulder abductor muscles both at the first visit and at the final follow-up. The presence of RCT was significantly associated with the recovery of the shoulder abductor muscles. The size of the RCT was negatively correlated with the MMT score of the shoulder abductor muscles at the final follow-up. The size of the RCT was independently correlated with the change of the MMT score of the shoulder abductor muscles. Conclusion: RCT was detected in >50% in patients with proximal type CSA, and the presence and severity of RCT can be used as prognostic factors for proximal type CSA patients who are treated conservatively. [ABSTRACT FROM AUTHOR]

Published
2022
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10. The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy

Author

Ishiwata, Sho, primary, Iizuka, Yoichi, additional, Shitara, Hitoshi, additional, Mieda, Tokue, additional, Takasawa, Eiji, additional, Tsunoda, Daisuke, additional, Kakuta, Yohei, additional, Honda, Akira, additional, Ito, Shunsuke, additional, Inomata, Kazuhiro, additional, Sasaki, Tsuyoshi, additional, Hamano, Noritaka, additional, Tajika, Tsuyoshi, additional, and Chikuda, Hirotaka, additional

Published
2020
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11. Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

Author

Kobayashi, Kazuyoshi, primary, Imagama, Shiro, additional, Ando, Kei, additional, Ishiguro, Naoki, additional, Yamashita, Masaomi, additional, Eguchi, Yawara, additional, Matsumoto, Morio, additional, Ishii, Ken, additional, Hikata, Tomohiro, additional, Seki, Shoji, additional, Terai, Hidetomi, additional, Suzuki, Akinobu, additional, Tamai, Koji, additional, Aramomi, Masaaki, additional, Ishikawa, Tetsuhiro, additional, Kimura, Atsushi, additional, Inoue, Hirokazu, additional, Inoue, Gen, additional, Miyagi, Masayuki, additional, Saito, Wataru, additional, Yamada, Kei, additional, Hongo, Michio, additional, Nishimura, Hirosuke, additional, Suzuki, Hidekazu, additional, Nakano, Atsushi, additional, Watanabe, Kazuyuki, additional, Chikuda, Hirotaka, additional, Ohya, Junichi, additional, Aoki, Yasuchika, additional, Shimizu, Masayuki, additional, Futatsugi, Toshimasa, additional, Mukaiyama, Keijiro, additional, Hasegawa, Masaichi, additional, Kiyasu, Katsuhito, additional, Iizuka, Haku, additional, Iizuka, Yoichi, additional, Kobayashi, Ryoichi, additional, Nishida, Kotaro, additional, Kakutani, Kenichiro, additional, Nakajima, Hideaki, additional, Murakami, Hideki, additional, Demura, Satoru, additional, Kato, Satoshi, additional, Yoshioka, Katsuhito, additional, Namikawa, Takashi, additional, Watanabe, Kei, additional, Nakanishi, Kazuyoshi, additional, Nakagawa, Yukihiro, additional, Yoshimoto, Mitsunori, additional, Fujiwara, Hiroyasu, additional, Nishida, Norihiro, additional, Imajo, Yasuaki, additional, Yamazaki, Masashi, additional, Sakane, Masataka, additional, Abe, Tetsuya, additional, Fujii, Kengo, additional, Kaito, Takashi, additional, Furuya, Takeo, additional, Orita, Sumihisa, additional, and Ohtori, Seiji, additional

Published
2017
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12. Risk Factors for Delirium After Spine Surgery in Extremely Elderly Patients Aged 80 Years or Older and Review of the Literature: Japan Association of Spine Surgeons with Ambition Multicenter Study

Author

Kobayashi, Kazuyoshi, primary, Imagama, Shiro, additional, Ando, Kei, additional, Ishiguro, Naoki, additional, Yamashita, Masaomi, additional, Eguchi, Yawara, additional, Matsumoto, Morio, additional, Ishii, Ken, additional, Hikata, Tomohiro, additional, Seki, Shoji, additional, Terai, Hidetomi, additional, Suzuki, Akinobu, additional, Tamai, Koji, additional, Aramomi, Masaaki, additional, Ishikawa, Tetsuhiro, additional, Kimura, Atsushi, additional, Inoue, Hirokazu, additional, Inoue, Gen, additional, Miyagi, Masayuki, additional, Saito, Wataru, additional, Yamada, Kei, additional, Hongo, Michio, additional, Matsuoka, Yuji, additional, Suzuki, Hidekazu, additional, Nakano, Atsushi, additional, Watanabe, Kazuyuki, additional, Chikuda, Hirotaka, additional, Ohya, Junichi, additional, Aoki, Yasuchika, additional, Shimizu, Masayuki, additional, Futatsugi, Toshimasa, additional, Mukaiyama, Keijiro, additional, Hasegawa, Masaichi, additional, Kiyasu, Katsuhito, additional, Iizuka, Haku, additional, Iizuka, Yoichi, additional, Kobayashi, Ryoichi, additional, Nishida, Kotaro, additional, Kakutani, Kenichiro, additional, Nakajima, Hideaki, additional, Murakami, Hideki, additional, Demura, Satoru, additional, Kato, Satoshi, additional, Yoshioka, Katsuhito, additional, Namikawa, Takashi, additional, Watanabe, Kei, additional, Nakanishi, Kazuyoshi, additional, Nakagawa, Yukihiro, additional, Yoshimoto, Mitsunori, additional, Fujiwara, Hiroyasu, additional, Nishida, Norihiro, additional, Imajo, Yasuaki, additional, Yamazaki, Masashi, additional, Sakane, Masataka, additional, Abe, Tetsuya, additional, Fujii, Kengo, additional, Kaito, Takashi, additional, Furuya, Takeo, additional, Orita, Sumihisa, additional, and Ohtori, Seiji, additional

Published
2017
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13. Prognosis of Cervical Diffuse Idiopathic Skeletal Hyperostosis-Related Spine Injuries in Elderly Patients: Analyses of Both Fracture and Spinal Cord Injury Without Fracture

Author

Segi, Naoki, Nakashima, Hiroaki, Machino, Masaaki, Ito, Sadayuki, Yokogawa, Noriaki, Sasagawa, Takeshi, Funayama, Toru, Eto, Fumihiko, Yamaji, Akihiro, Watanabe, Kota, Nori, Satoshi, Takeda, Kazuki, Furuya, Takeo, Yunde, Atsushi, Nakajima, Hideaki, Yamada, Tomohiro, Hasegawa, Tomohiko, Terashima, Yoshinori, Hirota, Ryosuke, Suzuki, Hidenori, Imajo, Yasuaki, Ikegami, Shota, Uehara, Masashi, Tonomura, Hitoshi, Sakata, Munehiro, Hashimoto, Ko, Onoda, Yoshito, Kawaguchi, Kenichi, Haruta, Yohei, Suzuki, Nobuyuki, Kato, Kenji, Uei, Hiroshi, Sawada, Hirokatsu, Nakanishi, Kazuo, Misaki, Kosuke, Terai, Hidetomi, Tamai, Koji, Shirasawa, Eiki, Inoue, Gen, Kakutani, Kenichiro, Kakiuchi, Yuji, Iizuka, Yoichi, Takasawa, Eiji, Akeda, Koji, Takegami, Norihiko, Kiyasu, Katsuhito, Tominaga, Hiroyuki, Tokumoto, Hiroto, Funao, Haruki, Oshima, Yasushi, Yoshii, Toshitaka, Kaito, Takashi, Sakai, Daisuke, Ohba, Tetsuro, Seki, Shoji, Otsuki, Bungo, Ishihara, Masayuki, Miyazaki, Masashi, Okada, Seiji, Imagama, Shiro, and Kato, Satoshi

Abstract

Study Design Retrospective multicenter study.Objective The purpose of this study was to compare the prognosis of elderly patients with injuries related to cervical diffuse idiopathic skeletal hyperostosis (cDISH) to matched control for each group, with and without fractures.Methods The current multicenter study was a retrospective analysis of 140 patients aged 65 years or older with cDISH-related cervical spine injuries; 106 fractures and 34 spinal cord injuries without fracture were identified. Propensity score–matched cohorts from 1363 patients without cDISH were generated and compared. Logistic regression analysis was performed to determine the risk of early mortality for patients with cDISH-related injury.Results Patients with cDISH-related injuries with fracture did not differ significantly in the incidence of each complication and ambulation or severity of paralysis compared to matched controls. In patients with cDISH-related injury without fracture, those who were nonambulatory at discharge comprised 55% vs 34% of controls, indicating significantly poorer ambulation in those with cDISH-related injuries (P= .023). There was no significant difference in the incidence of complications and ambulation or paralysis severity at 6 months as compared with controls. Fourteen patients died within 3 months. Logistic regression analysis identified complete paralysis (odds ratio [OR] 36.99) and age (OR 1.24) as significant risk factors for mortality.Conclusions The current study showed no significant differences in the incidence of complications, ambulation outcomes between patients with cDISH-related injury with fracture and matched controls, and that the ambulation at discharge for patients with cDISH-related injury without fractures were significantly inferior to those of matched controls.

Published
2024
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14. Prognosis of Cervical Diffuse Idiopathic Skeletal Hyperostosis-Related Spine Injuries in Elderly Patients: Analyses of Both Fracture and Spinal Cord Injury Without Fracture.

Author

Segi N, Nakashima H, Machino M, Ito S, Yokogawa N, Sasagawa T, Funayama T, Eto F, Yamaji A, Watanabe K, Nori S, Takeda K, Furuya T, Yunde A, Nakajima H, Yamada T, Hasegawa T, Terashima Y, Hirota R, Suzuki H, Imajo Y, Ikegami S, Uehara M, Tonomura H, Sakata M, Hashimoto K, Onoda Y, Kawaguchi K, Haruta Y, Suzuki N, Kato K, Uei H, Sawada H, Nakanishi K, Misaki K, Terai H, Tamai K, Shirasawa E, Inoue G, Kakutani K, Kakiuchi Y, Iizuka Y, Takasawa E, Akeda K, Takegami N, Kiyasu K, Tominaga H, Tokumoto H, Funao H, Oshima Y, Yoshii T, Kaito T, Sakai D, Ohba T, Seki S, Otsuki B, Ishihara M, Miyazaki M, Okada S, Imagama S, and Kato S

Abstract

Study Design: Retrospective multicenter study., Objective: The purpose of this study was to compare the prognosis of elderly patients with injuries related to cervical diffuse idiopathic skeletal hyperostosis (cDISH) to matched control for each group, with and without fractures., Methods: The current multicenter study was a retrospective analysis of 140 patients aged 65 years or older with cDISH-related cervical spine injuries; 106 fractures and 34 spinal cord injuries without fracture were identified. Propensity score-matched cohorts from 1363 patients without cDISH were generated and compared. Logistic regression analysis was performed to determine the risk of early mortality for patients with cDISH-related injury., Results: Patients with cDISH-related injuries with fracture did not differ significantly in the incidence of each complication and ambulation or severity of paralysis compared to matched controls. In patients with cDISH-related injury without fracture, those who were nonambulatory at discharge comprised 55% vs 34% of controls, indicating significantly poorer ambulation in those with cDISH-related injuries ( P = .023). There was no significant difference in the incidence of complications and ambulation or paralysis severity at 6 months as compared with controls. Fourteen patients died within 3 months. Logistic regression analysis identified complete paralysis (odds ratio [OR] 36.99) and age (OR 1.24) as significant risk factors for mortality., Conclusions: The current study showed no significant differences in the incidence of complications, ambulation outcomes between patients with cDISH-related injury with fracture and matched controls, and that the ambulation at discharge for patients with cDISH-related injury without fractures were significantly inferior to those of matched controls., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2023
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