Prognosis of Cervical Diffuse Idiopathic Skeletal Hyperostosis-Related Spine Injuries in Elderly Patients: Analyses of Both Fracture and Spinal Cord Injury Without Fracture.
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Segi Naoki, Nakashima Hiroaki, Machino Masaaki, Ito Sadayuki, Yokogawa Noriaki, Sasagawa Takeshi, Funayama Toru, Eto Fumihiko, Yamaji Akihiro, Watanabe Kota, Nori Satoshi, Takeda Kazuki, Furuya Takeo, Yunde Atsushi, Nakajima Hideaki, Yamada Tomohiro, Hasegawa Tomohiko, Terashima Yoshinori, Hirota Ryosuke, Suzuki Hidenori, Imajo Yasuaki, Ikegami Shota, Uehara Masashi, Tonomura Hitoshi, Sakata Munehiro, Hashimoto Ko, Onoda Yoshito, Kawaguchi Kenichi, Haruta Yohei, Suzuki Nobuyuki, Kato Kenji, Uei Hiroshi, Sawada Hirokatsu, Nakanishi Kazuo, Misaki Kosuke, Terai Hidetomi, Tamai Koji, Shirasawa Eiki, Inoue Gen, Kakutani Kenichiro, Kakiuchi Yuji, Iizuka Yoichi, Takasawa Eiji, Akeda Koji, Takegami Norihiko, Kiyasu Katsuhito, Tominaga Hiroyuki, Tokumoto Hiroto, Funao Haruki, Oshima Yasushi, Yoshii Toshitaka, Kaito Takashi, Sakai Daisuke, Ohba Tetsuro, Seki Shoji, Otsuki Bungo, Ishihara Masayuki, Miyazaki Masashi, Okada Seiji, Imagama Shiro, Kato Satoshi
Аннотация
OBJECTIVE: The purpose of this study was to compare the prognosis of elderly patients with injuries related to cervical diffuse idiopathic skeletal hyperostosis (cDISH) to matched control for each group, with and without fractures.
METHODS: The current multicenter study was a retrospective analysis of 140 patients aged 65 years or older with cDISH-related cervical spine injuries; 106 fractures and 34 spinal cord injuries without fracture were identified. Propensity score-matched cohorts from 1363 patients without cDISH were generated and compared. Logistic regression analysis was performed to determine the risk of early mortality for patients with cDISH-related injury.
RESULTS: Patients with cDISH-related injuries with fracture did not differ significantly in the incidence of each complication and ambulation or severity of paralysis compared to matched controls. In patients with cDISH-related injury without fracture, those who were nonambulatory at discharge comprised 55% vs 34% of controls, indicating significantly poorer ambulation in those with cDISH-related injuries (P = .023). There was no significant difference in the incidence of complications and ambulation or paralysis severity at 6 months as compared with controls. Fourteen patients died within 3 months. Logistic regression analysis identified complete paralysis (odds ratio [OR] 36.99) and age (OR 1.24) as significant risk factors for mortality.
CONCLUSIONS: The current study showed no significant differences in the incidence of complications, ambulation outcomes between patients with cDISH-related injury with fracture and matched controls, and that the ambulation at discharge for patients with cDISH-related injury without fractures were significantly inferior to those of matched controls.