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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 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Blunt Cerebrovascular Injury in the Elderly With Traumatic Cervical Spine Injuries: Results of a Retrospective Multi-Center Study of 1512 Cases in Japan. |
| 掲載誌名 | 正式名：Journal of neurotrauma 略 称：J Neurotrauma ISSNコード：15579042/08977151 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 40(11-12),pp.1164-1172 |
| 著者・共著者 | Hidenori Suzuki, Masahiro Funaba, Yasuaki Imajo, Noriaki Yokogawa, Takeshi Sasagawa, Kei Ando, Hiroaki Nakashima, Naoki Segi, Toru Funayama, Fumihiko Eto, Kota Watanabe, Junichi Yamane, Takeo Furuya, Hideaki Nakajima, Tomohiko Hasegawa, Yoshinori Terashima, Shota Ikegami, Gen Inoue, Takashi Kaito, Satoshi Kato, Japan Association of Spine Surgeons with Ambition (JASA) Study Group |
| 発行年月 | 2023/06 |
| 概要 | This study is nationwide retrospective multi-center study to investigate the incidence and characteristics of blunt cerebrovascular injury (BCVI) in elderly Japanese patients with traumatic cervical spine injuries (CSI) including spinal cord injury (SCI) without major bone injury. The study enrolled 1512 patients (average age: 75.8 ± 6.9 years; 1007 males, 505 females) from 33 nationwide institutions, and 391 (26%) of the participants had digital subtraction angiography and/or computed tomography angiography. Fifty-three patients were diagnosed as having BCVI by angiography. We assessed neurological evaluation, comorbidities and classification of CSI in the elderly patients with/without BCVI and collected 6-month follow-up data on treatment, complications, and patient outcome. We also statistically analyzed the relative risk (RR) and relationship between BCVI and other factors. Significant differences were identified between BCVI (+) (n = 53) and (-) (n = 1459) patients with American Spinal Injury Association Impairment Scale (ASIA) A, C, D, cervical fracture, C3-7 injury level (AO type F and/or C), cervical dislocation, spinal surgery for CSI, tetraplegia type of SCI, and/or head injury. Fifty-three (3.5%) elderly patients had CSI complicated by BCVI including 10 (19%) cases of Denver grade I, four (7%) of grade II, 1 (2%) of grade III, 29 (55%) of grade IV, and nine (17%) of grade V. Sixteen cases were treated by interventional radiology. Rates of mortality and brain infarction from BCVI were 0.13% and 0.40%, respectively. RR of BCVI was significantly higher in the elderly cervical injury patients with head injury, severe neurological deficit, ASIA A (RR: 4.33), cervical fracture at the C3-7 level (RR: 7.39), and cervical dislocation at the C1-6 level (RR: 3.06-7.18). In conclusion, 53 (3.5%) elderly patients were complicated with BCVI. BCVI more frequently complicated head injury, severe neurological deficit (ASIA A or tetraplegia), AO type F, and/or C fractures |
| DOI | 10.1089/neu.2022.0180 |
| PMID | 36719766 |