Kazuo Nakanishi
   Department   Kawasaki University of Medical Welfare  ,
   Position   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