ナカニシ　カズオ   Kazuo Nakanishi   中西　一夫    所属   川崎医療福祉大学  リハビリテーション学部 理学療法学科    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Early Versus Delayed Surgery for Elderly Traumatic Cervical Spinal Injury: A Nationwide Multicenter Study in Japan.
掲載誌名	正式名：Global spine journal 略　 称：Global Spine J ISSNコード：21925682/21925682
掲載区分	国外
巻・号・頁	pp.21925682241227430
著者・共著者	Naoki Segi, Hiroaki Nakashima, Sadayuki Ito, Noriaki Yokogawa, Takeshi Sasagawa, Kota Watanabe, Satoshi Nori, Toru Funayama, Fumihiko Eto, Hideaki Nakajima, Yoshinori Terashima, Ryosuke Hirota, Ko Hashimoto, Yoshito Onoda, Takeo Furuya, Atsushi Yunde, Shota Ikegami, Masashi Uehara, Hidenori Suzuki, Yasuaki Imajo, Hiroshi Uei, Hirokatsu Sawada, Kenichi Kawaguchi, Kazuo Nakanishi, Nobuyuki Suzuki, Yasushi Oshima, Tomohiko Hasegawa, Yoichi Iizuka, Hitoshi Tonomura, Hidetomi Terai, Koji Akeda, Shoji Seki, Masayuki Ishihara, Gen Inoue, Haruki Funao, Toshitaka Yoshii, Takashi Kaito, Katsuhito Kiyasu, Hiroyuki Tominaga, Kenichiro Kakutani, Daisuke Sakai, Tetsuro Ohba, Bungo Otsuki, Masashi Miyazaki, Kenta Murotani, Seiji Okada, Shiro Imagama, Satoshi Kato
発行年月	2024/01/16
概要	STUDY DESIGN:Retrospective multicenter study.OBJECTIVES:The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear. This study investigated whether early surgery for CSI in elderly affects complication rates and neurological outcomes.METHODS:This retrospective multicenter study included 462 patients. We included patients with traumatic acute cervical spinal cord injury aged ≥65 years who were treated surgically, whereas patients with American Spinal Injury Association (ASIA) Impairment Scale E, those with unknown operative procedures, and those waiting for surgery for >1 month were excluded. The minimum follow-up period was 6 months. Sixty-five patients (early group, 14.1%) underwent surgical treatment within 24 hours, whereas the remaining 397 patients (85.9%) underwent surgery on a standby basis (delayed group). The propensity score-matched cohorts of 63 cases were compared.RESULTS:Patients in the early group were significantly younger, had significantly more subaxial dislocations (and fractures), tetraplegia, significantly lower ASIA motor scores, and ambulatory abilities 6 months after injury. However, no significant differences in the rate of complications, ambulatory abilities, or ASIA Impairment Scale scores 6 months after injury were observed between the matched cohorts. At 6 months after injury, 61% of the patients in the early group (25% unsupported and 36% supported) and 53% of the patients in the delayed group (34% unsupported and 19% supported) were ambulatory.CONCLUSIONS:Early surgery is possible for CSI in elderly patients as the matched cohort reveals no significant difference in complication rates and neurological or ambulatory recovery between the early and delayed surgery groups.
DOI	10.1177/21925682241227430
PMID	38229410