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 | Does surgery improve neurological outcomes in older individuals with cervical spinal cord injury without bone injury? A multicenter study. |
掲載誌名 | 正式名:Spinal cord 略 称:Spinal Cord ISSNコード:14765624/13624393 |
掲載区分 | 国外 |
巻・号・頁 | 60(10),pp.895-902 |
著者・共著者 | Nori Satoshi, Watanabe Kota, Takeda Kazuki, et.al. |
発行年月 | 2022/10 |
概要 | STUDY DESIGN:Retrospective multicenter study.OBJECTIVES:To investigate the neurological outcomes of older individuals treated with surgery versus conservative treatment for cervical spinal cord injury (CSCI) without bone injury.SETTING:Thirty-three medical institutions in Japan.METHODS:This study included 317 consecutive persons aged ≥65 years with CSCI without bone injury in participating institutes between 2010 and 2020. The participants were followed up for at least 6 months after the injury. Individuals were divided into surgery (n = 114) and conservative treatment (n = 203) groups. To compare neurological outcomes and complications between the groups, propensity score matching of the baseline factors (characteristics, comorbidities, and neurological function) was performed.RESULTS:After propensity score matching, the surgery and conservative treatment groups comprised 89 individuals each. Surgery was performed at a median of 9.0 (3-17) days after CSCI. Baseline factors were comparable between groups, and the standardized difference in the covariates in the matched cohort was <10%. The American Spinal Injury Association (ASIA) impairment scale grade and ASIA motor score (AMS) 6 months after injury and changes in the AMS from baseline to 6 months after injury were not significantly different between groups (P = 0.63, P = 0.24, and P = 0.75, respectively). Few participants who underwent surgery demonstrated perioperative complications such as dural tear (1.1%), surgical site infection (2.2%), and C5 palsy (5.6%).CONCLUSION:Conservative treatment is suggested to be a more favorable option for older individuals with CSCI without bone injuries, but this finding requires further validation. |
DOI | 10.1038/s41393-022-00818-6 |
PMID | 35690640 |