Kazuo Nakanishi
   Department   Kawasaki University of Medical Welfare  ,
   Position   Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Prognostic Factors for Cervical Spinal Cord Injury without Major Bone Injury in Elderly Patients.
Journal Formal name：Journal of neurotrauma
Abbreviation：J Neurotrauma
ISSN code：15579042/08977151
Domestic / ForeginForegin
Volume, Issue, Page 39(9-10),pp.658-666
Author and coauthor Nakajima Hideaki, Yokogawa Noriaki, Sasagawa Takeshi, et.al.
Publication date 2022/05
Summary In the current aging society, there has been a marked increase in the incidence of cervical spinal cord injury (CSCI) without major bone injury. This multi-center study aimed to identify predictors of neurological improvement in elderly patients with CSCI without major bone injury. The participants were 591 patients aged ≥65 years with CSCI without major bone injury and a minimum follow-up period of three months. Neurologic status was defined using the American Spinal Injury Association (ASIA) impairment scale (AIS). Univariate and multi-variate analyses were performed to identify prognostic factors for walking recovery in AIS A-C cases and full upper extremity motor recovery in AIS D cases. In AIS A-C cases, body mass index (odds ratio (OR): 1.112), magnetic resonance imaging signal change (OR: 0.240), AIS on admission (OR: 3.497), comorbidity of dementia/delirium (OR: 0.365), and post-injury pneumonia (OR: 0.194) were identified as independent prognostic factors for walking recovery. The prevalence of ossification of the posterior longitudinal ligament (OR: 0.494) was also found to be an independent prognostic factor in AIS B and C cases only. In AIS D cases, age (OR: 0.937), upper extremity ASIA motor score on admission (OR: 1.230 [per 5 scores]), and operation (OR: 0.519) were independent prognostic factors for full motor recovery. The severity of AIS at admission was the strongest predictor of functional outcomes. Promoting rehabilitation, however, through measures to reduce cognitive changes, post-injury pneumonia, and unhealthy body weight changes can contribute to greater neurological improvement in AIS A-C cases.
DOI 10.1089/neu.2021.0351
PMID 35044252