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	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