Kazuo Nakanishi
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Bone and Joint Surgery,
   Position   Associate Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Does surgery improve neurological outcomes in older individuals with cervical spinal cord injury without bone injury? A multicenter study.
Journal Formal name：Spinal cord
Abbreviation：Spinal Cord
ISSN code：14765624/13624393
Domestic / ForeginForegin
Volume, Issue, Page 60(10),pp.895-902
Author and coauthor Nori Satoshi, Watanabe Kota, Takeda Kazuki, et.al.
Publication date 2022/10
Summary 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