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

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

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Study Design: Retrospective multicenter study Objectives: 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.

Original languageEnglish
JournalGlobal Spine Journal
DOIs
Publication statusAccepted/In press - 2023

Keywords

  • cervical fracture
  • cervical spinal cord injury
  • elderly
  • instrumentation surgery
  • operative complication
  • surgical treatment modality

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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