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1. 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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2. 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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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, 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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4. 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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5. 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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6. Influence of Diabetes Mellitus on Neurological Recovery in Older Patients With Cervical Spinal Cord Injury Without Bone Injury: A Retrospective Multicenter Study

Author

Takeda, Kazuki, Watanabe, Kota, Nori, Satoshi, Yamane, Junichi, Kono, Hitoshi, Yokogawa, Noriaki, Sasagawa, Takeshi, Nakashima, Hiroaki, Segi, Naoki, Funayama, Toru, Eto, Fumihiko, Furuya, Takeo, Yunde, Atsushi, Nakajima, Hideaki, Yamada, Tomohiro, Hasegawa, Tomohiko, Terashima, Yoshinori, Hirota, Ryosuke, Suzuki, Hidenori, Imajo, Yasuaki, Ikegami, Shota, Tonomura, Hitoshi, Sakata, Munehiro, Hashimoto, Ko, Kawaguchi, Kenichi, Suzuki, Nobuyuki, Uei, Hiroshi, Nakanishi, Kazuo, Terai, Hidetomi, Inoue, Gen, Kiyasu, Katsuhito, Iizuka, Yoichi, Akeda, Koji, Funao, Haruki, Oshima, Yasushi, Kaito, Takashi, Yoshii, Toshitaka, Ishihara, Masayuki, Okada, Seiji, Imagama, Shiro, and Kato, Satoshi

Abstract

Study Design Retrospective study.Objectives To investigate the impact of diabetes mellitus on neurological recovery and determine the relationship between moderate-severe diabetes and neurological recovery in patients with cervical spinal cord injury (CSCI) without bone injury.Methods A retrospective study was conducted on 389 consecutive patients aged ≥65 years with CSCI without bone injury across 33 medical institutes. The patients were divided into a nondiabetic group (n = 270) and a diabetic group (n = 119). Neurological outcomes were compared between the two groups through propensity score matching. The impact of moderate-severe diabetes (defined as hemoglobin A1c ≥ 7.0% or requiring insulin treatment) on neurological recovery was evaluated through multiple linear regression analysis.Results Propensity score matching revealed no significant differences between the diabetic and nondiabetic groups in terms of American Spinal Injury Association (ASIA) impairment scale grade and mean total ASIA motor scores (AMS) at 6 months post-injury. Multiple linear regression analysis indicated that age on admission (B = −0.34; 95% confidence interval [CI], −0.59 to −0.08; P= 0.01), dementia (B = −16.50; 95% CI, −24.99 to −8.01; P< 0.01), and baseline total AMS (B = −0.62; 95% CI, −0.72 to −0.51; P< 0.01) were negative predictors of neurological recovery at 6 months post-injury. The presence of moderate-severe diabetes did not influence neurological recovery at 6 months post-injury.Conclusions Diabetic patients with CSCI without bone injury achieved improvements in neurological function comparable to those of nondiabetic patients. Moderate-severe diabetes did not affect neurological recovery in patients with CSCI without bone injury.

Published
2024
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7. Hangman’s Fracture in Geriatric Population: A Nationwide Multicenter Study in Japan

Author

Yunde, Atsushi, Furuya, Takeo, Orita, Sumihisa, Ohtori, Seiji, Yokogawa, Noriaki, Nakashima, Hiroaki, Segi, Naoki, Funayama, Toru, Ikegami, Shota, Nakajima, Hideaki, Watanabe, Kota, Hasegawa, Tomohiko, Tonomura, Hitoshi, Terashima, Yoshinori, Hashimoto, Ko, Suzuki, Nobuyuki, Uei, Hiroshi, Kiyasu, Katsuhito, Tominaga, Hiroyuki, Sakai, Daisuke, Kaito, Takashi, Inoue, Gen, Okada, Seiji, Imagama, Shiro, and Kato, Satoshi

Abstract

Study Design Retrospective multicenter study.Objectives To investigate the treatments of the geriatric population with hangman’s fractures using a multicenter database under the Japan Association of Spine Surgeons with Ambition (JASA).Methods The multicenter database included data from 1512 patients. We employed the Levine and Edwards classification for categorizing hangman’s fractures. The study incorporated epidemiological data, including the prevalence of hangman’s fractures, patient age, and follow-up duration. Bony fusion rates and length of hospitalization were recorded for Type I and Type II fractures, and the degree of neurological impairment was assessed.Results Hangman’s fractures represented 62 cases, accounting for 7.4% of all cervical spine injuries. The patients had an average age of 76.6 ± 6.5 years, and the mean duration of follow-up was 21.5 ± 23.6 months. The study found that the bony fusion rate for hangman’s fractures in the geriatric population was 88.9%. Surgical treatment was associated with a shorter hospitalization period for Type II fractures compared to conservative treatment. Thirteen cases of hangman’s fractures in the geriatric population, accounting for 21%, were complicated by spinal cord injury.Conclusions This is the largest study to date on hangman’s fractures in geriatric population ≥65 years. Type I and Type II fractures, according to the Levine and Edwards classification, had a bony fusion rate of up to 90%. In patients with Type II fractures, surgical treatment led to a shorter initial hospital stay. Geriatric patients are at risk of spinal cord injury due to hangman’s fractures.

Published
2024
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8. 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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9. Hangman's Fracture in Geriatric Population: A Nationwide Multicenter Study in Japan.

Author

Yunde A, Furuya T, Orita S, Ohtori S, Yokogawa N, Nakashima H, Segi N, Funayama T, Ikegami S, Nakajima H, Watanabe K, Hasegawa T, Tonomura H, Terashima Y, Hashimoto K, Suzuki N, Uei H, Kiyasu K, Tominaga H, Sakai D, Kaito T, Inoue G, Okada S, Imagama S, and Kato S

Abstract

Study Design: Retrospective multicenter study., Objectives: To investigate the treatments of the geriatric population with hangman's fractures using a multicenter database under the Japan Association of Spine Surgeons with Ambition (JASA)., Methods: The multicenter database included data from 1512 patients. We employed the Levine and Edwards classification for categorizing hangman's fractures. The study incorporated epidemiological data, including the prevalence of hangman's fractures, patient age, and follow-up duration. Bony fusion rates and length of hospitalization were recorded for Type I and Type II fractures, and the degree of neurological impairment was assessed., Results: Hangman's fractures represented 62 cases, accounting for 7.4% of all cervical spine injuries. The patients had an average age of 76.6 ± 6.5 years, and the mean duration of follow-up was 21.5 ± 23.6 months. The study found that the bony fusion rate for hangman's fractures in the geriatric population was 88.9%. Surgical treatment was associated with a shorter hospitalization period for Type II fractures compared to conservative treatment. Thirteen cases of hangman's fractures in the geriatric population, accounting for 21%, were complicated by spinal cord injury., Conclusions: This is the largest study to date on hangman's fractures in geriatric population ≥65 years. Type I and Type II fractures, according to the Levine and Edwards classification, had a bony fusion rate of up to 90%. In patients with Type II fractures, surgical treatment led to a shorter initial hospital stay. Geriatric patients are at risk of spinal cord injury due to hangman's fractures., 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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10. 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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