Cervical Spinal Cord Injury Without Bony Injury: A Multicenter Retrospective Study of Emergency and Critical Care Centers in Japan
BACKGROUND:To demonstrate the clinical characteristics of patients with cervical cord injury (CCI) without bony injury in Japan. METHODS:Retrospective review of 127 patients with CCI without bony injury treated between January 2003 and October 2005 at 11 institutions. RESULTS:Prevalence of CCI witho...
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| Veröffentlicht in: | The Journal of trauma, injury, infection, and critical care injury, infection, and critical care, 2008-08, Vol.65 (2), p.373-379 |
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| creator | Kato, Hiroshi Kimura, Akio Sasaki, Ryo Kaneko, Naoyuki Takeda, Munekazu Hagiwara, Akiyoshi Ogura, Shinji Mizoguchi, Takashi Matsuoka, Tetsuya Ono, Hidehumi Matsuura, Kenji Matsushima, Kazuhide Kushimoto, Shigeki Fuse, Akira Nakatani, Toshio Iwase, Masaaki Fudoji, Junmei Kasai, Takeshi |
| description | BACKGROUND:To demonstrate the clinical characteristics of patients with cervical cord injury (CCI) without bony injury in Japan.
METHODS:Retrospective review of 127 patients with CCI without bony injury treated between January 2003 and October 2005 at 11 institutions.
RESULTS:Prevalence of CCI without bony injury was 32.2% among all CCIs and 0.81% among all blunt traumas. Mean age was 60.4 years (range, 19–90 years), with 104 patients (82%) ≥46 years old (older group). The major mechanism of injury among younger patients ( |
| doi_str_mv | 10.1097/TA.0b013e31817db11d |
| format | Article |
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METHODS:Retrospective review of 127 patients with CCI without bony injury treated between January 2003 and October 2005 at 11 institutions.
RESULTS:Prevalence of CCI without bony injury was 32.2% among all CCIs and 0.81% among all blunt traumas. Mean age was 60.4 years (range, 19–90 years), with 104 patients (82%) ≥46 years old (older group). The major mechanism of injury among younger patients (<46 years) was traffic injuries (39%), whereas minor falls (44%) predominated in older patients. High-energy mechanisms of injury were significantly more common for younger patients (35% versus 15%, p = 0.041). Mean injury severity score, abbreviated injury score for the head and Glasgow coma scale on admission were 17.2 ± 4.7, 0.6 ± 0.9, and 14.2 ± 2.1, respectively. Incomplete CCI occurred in 88.7%. On plain cervical spine radiography, spinal canal stenosis and spondylosis or ossification of the posterior longitudinal ligament were more frequent in older patients than in younger patients (43% vs. 13%, p = 0.008; 54% vs. 17%, p = 0.002, respectively). No abnormal findings were seen in 52% of younger patients.
CONCLUSION:CCI without bony injury occurred more frequently in this study population than previously reported. Degenerative changes and spinal canal stenosis represent important risk factors for developing CCI without bony injury and the present results suggest that this injury may occur in younger adults during high-energy injuries in the absence of pre-existing cervical spine disease.</description><identifier>ISSN: 0022-5282</identifier><identifier>EISSN: 1529-8809</identifier><identifier>DOI: 10.1097/TA.0b013e31817db11d</identifier><identifier>PMID: 18695474</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Accidental Falls - statistics & numerical data ; Accidents, Traffic - statistics & numerical data ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cerebrospinal fluid. Meninges. Spinal cord ; Cervical Vertebrae ; Diseases of the osteoarticular system ; Female ; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation ; Glasgow Coma Scale ; Humans ; Injury Severity Score ; Japan - epidemiology ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Retrospective Studies ; Spinal Cord Injuries - epidemiology ; Spinal Cord Injuries - therapy ; Spinal Osteophytosis - therapy ; Spinal Stenosis - therapy</subject><ispartof>The Journal of trauma, injury, infection, and critical care, 2008-08, Vol.65 (2), p.373-379</ispartof><rights>2008 Lippincott Williams & Wilkins, Inc.</rights><rights>2008 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5147-61f53d3035433c1255d925d70767e7dab27ccbb399e23278cc7e05d24868006d3</citedby><cites>FETCH-LOGICAL-c5147-61f53d3035433c1255d925d70767e7dab27ccbb399e23278cc7e05d24868006d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20585168$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18695474$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kato, Hiroshi</creatorcontrib><creatorcontrib>Kimura, Akio</creatorcontrib><creatorcontrib>Sasaki, Ryo</creatorcontrib><creatorcontrib>Kaneko, Naoyuki</creatorcontrib><creatorcontrib>Takeda, Munekazu</creatorcontrib><creatorcontrib>Hagiwara, Akiyoshi</creatorcontrib><creatorcontrib>Ogura, Shinji</creatorcontrib><creatorcontrib>Mizoguchi, Takashi</creatorcontrib><creatorcontrib>Matsuoka, Tetsuya</creatorcontrib><creatorcontrib>Ono, Hidehumi</creatorcontrib><creatorcontrib>Matsuura, Kenji</creatorcontrib><creatorcontrib>Matsushima, Kazuhide</creatorcontrib><creatorcontrib>Kushimoto, Shigeki</creatorcontrib><creatorcontrib>Fuse, Akira</creatorcontrib><creatorcontrib>Nakatani, Toshio</creatorcontrib><creatorcontrib>Iwase, Masaaki</creatorcontrib><creatorcontrib>Fudoji, Junmei</creatorcontrib><creatorcontrib>Kasai, Takeshi</creatorcontrib><title>Cervical Spinal Cord Injury Without Bony Injury: A Multicenter Retrospective Study of Emergency and Critical Care Centers in Japan</title><title>The Journal of trauma, injury, infection, and critical care</title><addtitle>J Trauma</addtitle><description>BACKGROUND:To demonstrate the clinical characteristics of patients with cervical cord injury (CCI) without bony injury in Japan.
METHODS:Retrospective review of 127 patients with CCI without bony injury treated between January 2003 and October 2005 at 11 institutions.
RESULTS:Prevalence of CCI without bony injury was 32.2% among all CCIs and 0.81% among all blunt traumas. Mean age was 60.4 years (range, 19–90 years), with 104 patients (82%) ≥46 years old (older group). The major mechanism of injury among younger patients (<46 years) was traffic injuries (39%), whereas minor falls (44%) predominated in older patients. High-energy mechanisms of injury were significantly more common for younger patients (35% versus 15%, p = 0.041). Mean injury severity score, abbreviated injury score for the head and Glasgow coma scale on admission were 17.2 ± 4.7, 0.6 ± 0.9, and 14.2 ± 2.1, respectively. Incomplete CCI occurred in 88.7%. On plain cervical spine radiography, spinal canal stenosis and spondylosis or ossification of the posterior longitudinal ligament were more frequent in older patients than in younger patients (43% vs. 13%, p = 0.008; 54% vs. 17%, p = 0.002, respectively). No abnormal findings were seen in 52% of younger patients.
CONCLUSION:CCI without bony injury occurred more frequently in this study population than previously reported. Degenerative changes and spinal canal stenosis represent important risk factors for developing CCI without bony injury and the present results suggest that this injury may occur in younger adults during high-energy injuries in the absence of pre-existing cervical spine disease.</description><subject>Accidental Falls - statistics & numerical data</subject><subject>Accidents, Traffic - statistics & numerical data</subject><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cerebrospinal fluid. Meninges. Spinal cord</subject><subject>Cervical Vertebrae</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</subject><subject>Glasgow Coma Scale</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Retrospective Studies</subject><subject>Spinal Cord Injuries - epidemiology</subject><subject>Spinal Cord Injuries - therapy</subject><subject>Spinal Osteophytosis - therapy</subject><subject>Spinal Stenosis - therapy</subject><issn>0022-5282</issn><issn>1529-8809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkd9r1TAUx4so7jr9CwTJi751nvxqUt-uZepkIrgrPpY0OfVm9qZd0m701b_cbrcoSAgHDp_vCfmcLHtJ4YxCqd7utmfQAOXIqabKNZS6R9mGSlbmWkP5ONsAMJZLptlJ9iylawAQguun2QnVRSmFEpvsd4Xx1lvTkavBh6VUfXTkIlxPcSY__Ljvp5G878O89t6RLfkydaO3GEaM5BuOsU8D2tHfIrkaJzeTviXnB4w_MdiZmOBIFf348EZlIpLqIZmID-SzGUx4nj1pTZfwxVpPs-8fznfVp_zy68eLanuZW0mFygvaSu44cCk4t5RJ6UomnQJVKFTONExZ2zS8LJFxprS1CkE6JnShAQrHT7M3x7lD7G8mTGN98Mli15mA_ZTqohS0LAqxgPwI2uVrKWJbD9EfTJxrCvW9-nq3rf9Xv6RereOn5oDuX2Z1vQCvV8CkRUYbTbA-_eUYSC1poRdOHLm7vrsX9aub7jDWezTduK-XJYLkiucMQC8HIF8uVfwPO5qc0Q</recordid><startdate>200808</startdate><enddate>200808</enddate><creator>Kato, Hiroshi</creator><creator>Kimura, Akio</creator><creator>Sasaki, Ryo</creator><creator>Kaneko, Naoyuki</creator><creator>Takeda, Munekazu</creator><creator>Hagiwara, Akiyoshi</creator><creator>Ogura, Shinji</creator><creator>Mizoguchi, Takashi</creator><creator>Matsuoka, Tetsuya</creator><creator>Ono, Hidehumi</creator><creator>Matsuura, Kenji</creator><creator>Matsushima, Kazuhide</creator><creator>Kushimoto, Shigeki</creator><creator>Fuse, Akira</creator><creator>Nakatani, Toshio</creator><creator>Iwase, Masaaki</creator><creator>Fudoji, Junmei</creator><creator>Kasai, Takeshi</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200808</creationdate><title>Cervical Spinal Cord Injury Without Bony Injury: A Multicenter Retrospective Study of Emergency and Critical Care Centers in Japan</title><author>Kato, Hiroshi ; Kimura, Akio ; Sasaki, Ryo ; Kaneko, Naoyuki ; Takeda, Munekazu ; Hagiwara, Akiyoshi ; Ogura, Shinji ; Mizoguchi, Takashi ; Matsuoka, Tetsuya ; Ono, Hidehumi ; Matsuura, Kenji ; Matsushima, Kazuhide ; Kushimoto, Shigeki ; Fuse, Akira ; Nakatani, Toshio ; Iwase, Masaaki ; Fudoji, Junmei ; Kasai, Takeshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5147-61f53d3035433c1255d925d70767e7dab27ccbb399e23278cc7e05d24868006d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Accidental Falls - statistics & numerical data</topic><topic>Accidents, Traffic - statistics & numerical data</topic><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cerebrospinal fluid. Meninges. Spinal cord</topic><topic>Cervical Vertebrae</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation</topic><topic>Glasgow Coma Scale</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Retrospective Studies</topic><topic>Spinal Cord Injuries - epidemiology</topic><topic>Spinal Cord Injuries - therapy</topic><topic>Spinal Osteophytosis - therapy</topic><topic>Spinal Stenosis - therapy</topic><toplevel>online_resources</toplevel><creatorcontrib>Kato, Hiroshi</creatorcontrib><creatorcontrib>Kimura, Akio</creatorcontrib><creatorcontrib>Sasaki, Ryo</creatorcontrib><creatorcontrib>Kaneko, Naoyuki</creatorcontrib><creatorcontrib>Takeda, Munekazu</creatorcontrib><creatorcontrib>Hagiwara, Akiyoshi</creatorcontrib><creatorcontrib>Ogura, Shinji</creatorcontrib><creatorcontrib>Mizoguchi, Takashi</creatorcontrib><creatorcontrib>Matsuoka, Tetsuya</creatorcontrib><creatorcontrib>Ono, Hidehumi</creatorcontrib><creatorcontrib>Matsuura, Kenji</creatorcontrib><creatorcontrib>Matsushima, Kazuhide</creatorcontrib><creatorcontrib>Kushimoto, Shigeki</creatorcontrib><creatorcontrib>Fuse, Akira</creatorcontrib><creatorcontrib>Nakatani, Toshio</creatorcontrib><creatorcontrib>Iwase, Masaaki</creatorcontrib><creatorcontrib>Fudoji, Junmei</creatorcontrib><creatorcontrib>Kasai, Takeshi</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of trauma, injury, infection, and critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kato, Hiroshi</au><au>Kimura, Akio</au><au>Sasaki, Ryo</au><au>Kaneko, Naoyuki</au><au>Takeda, Munekazu</au><au>Hagiwara, Akiyoshi</au><au>Ogura, Shinji</au><au>Mizoguchi, Takashi</au><au>Matsuoka, Tetsuya</au><au>Ono, Hidehumi</au><au>Matsuura, Kenji</au><au>Matsushima, Kazuhide</au><au>Kushimoto, Shigeki</au><au>Fuse, Akira</au><au>Nakatani, Toshio</au><au>Iwase, Masaaki</au><au>Fudoji, Junmei</au><au>Kasai, Takeshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cervical Spinal Cord Injury Without Bony Injury: A Multicenter Retrospective Study of Emergency and Critical Care Centers in Japan</atitle><jtitle>The Journal of trauma, injury, infection, and critical care</jtitle><addtitle>J Trauma</addtitle><date>2008-08</date><risdate>2008</risdate><volume>65</volume><issue>2</issue><spage>373</spage><epage>379</epage><pages>373-379</pages><issn>0022-5282</issn><eissn>1529-8809</eissn><abstract>BACKGROUND:To demonstrate the clinical characteristics of patients with cervical cord injury (CCI) without bony injury in Japan.
METHODS:Retrospective review of 127 patients with CCI without bony injury treated between January 2003 and October 2005 at 11 institutions.
RESULTS:Prevalence of CCI without bony injury was 32.2% among all CCIs and 0.81% among all blunt traumas. Mean age was 60.4 years (range, 19–90 years), with 104 patients (82%) ≥46 years old (older group). The major mechanism of injury among younger patients (<46 years) was traffic injuries (39%), whereas minor falls (44%) predominated in older patients. High-energy mechanisms of injury were significantly more common for younger patients (35% versus 15%, p = 0.041). Mean injury severity score, abbreviated injury score for the head and Glasgow coma scale on admission were 17.2 ± 4.7, 0.6 ± 0.9, and 14.2 ± 2.1, respectively. Incomplete CCI occurred in 88.7%. On plain cervical spine radiography, spinal canal stenosis and spondylosis or ossification of the posterior longitudinal ligament were more frequent in older patients than in younger patients (43% vs. 13%, p = 0.008; 54% vs. 17%, p = 0.002, respectively). No abnormal findings were seen in 52% of younger patients.
CONCLUSION:CCI without bony injury occurred more frequently in this study population than previously reported. Degenerative changes and spinal canal stenosis represent important risk factors for developing CCI without bony injury and the present results suggest that this injury may occur in younger adults during high-energy injuries in the absence of pre-existing cervical spine disease.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>18695474</pmid><doi>10.1097/TA.0b013e31817db11d</doi><tpages>7</tpages></addata></record> |
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| ispartof | The Journal of trauma, injury, infection, and critical care, 2008-08, Vol.65 (2), p.373-379 |
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| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Accidental Falls - statistics & numerical data Accidents, Traffic - statistics & numerical data Adult Age Distribution Aged Aged, 80 and over Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cerebrospinal fluid. Meninges. Spinal cord Cervical Vertebrae Diseases of the osteoarticular system Female General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation Glasgow Coma Scale Humans Injury Severity Score Japan - epidemiology Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Retrospective Studies Spinal Cord Injuries - epidemiology Spinal Cord Injuries - therapy Spinal Osteophytosis - therapy Spinal Stenosis - therapy |
| title | Cervical Spinal Cord Injury Without Bony Injury: A Multicenter Retrospective Study of Emergency and Critical Care Centers in Japan |
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