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Multicenter Study
. 2022 Aug 20;23(1):798.
doi: 10.1186/s12891-022-05752-5.

A multicenter study of 1-year mortality and walking capacity after spinal fusion surgery for cervical fracture in elderly patients

Takeshi Sasagawa  1   2 , Noriaki Yokogawa  1 , Hiroyuki Hayashi  1   3 , Hiroyuki Tsuchiya  1 , Kei Ando  4 , Hiroaki Nakashima  4 , Naoki Segi  4 , Kota Watanabe  5 , Satoshi Nori  5 , Kazuki Takeda  5   6 , Takeo Furuya  7 , Atsushi Yunde  7 , Shota Ikegami  8 , Masashi Uehara  8 , Hidenori Suzuki  9 , Yasuaki Imajo  9 , Toru Funayama  10 , Fumihiko Eto  11 , Akihiro Yamaji  12 , Ko Hashimoto  13 , Yoshito Onoda  13 , Kenichiro Kakutani  14 , Yuji Kakiuchi  14 , Nobuyuki Suzuki  15 , Kenji Kato  15 , Yoshinori Terashima  16   17 , Ryosuke Hirota  16 , Tomohiro Yamada  18   19 , Tomohiko Hasegawa  18 , Kenichi Kawaguchi  20 , Yohei Haruta  20 , Shoji Seki  21 , Hitoshi Tonomura  22 , Munehiro Sakata  22   23 , Hiroshi Uei  24   25 , Hirokatsu Sawada  25 , Hiroyuki Tominaga  26 , Hiroto Tokumoto  26 , Takashi Kaito  27 , Yoichi Iizuka  28 , Eiji Takasawa  28 , Yasushi Oshima  29 , Hidetomi Terai  30 , Koji Tamai  30 , Bungo Otsuki  31 , Masashi Miyazaki  32 , Hideaki Nakajima  33 , Kazuo Nakanishi  34 , Kosuke Misaki  34 , Gen Inoue  35 , Katsuhito Kiyasu  36 , Koji Akeda  37 , Norihiko Takegami  37 , Toshitaka Yoshii  38 , Masayuki Ishihara  39 , Seiji Okada  27 , Yasuchika Aoki  40 , Katsumi Harimaya  41 , Hideki Murakami  15 , Ken Ishii  42   43   44 , Seiji Ohtori  7 , Shiro Imagama  4 , Satoshi Kato  45
Affiliations
Multicenter Study

A multicenter study of 1-year mortality and walking capacity after spinal fusion surgery for cervical fracture in elderly patients

Takeshi Sasagawa et al. BMC Musculoskelet Disord. .

Abstract

Background: The 1-year mortality and functional prognoses of patients who received surgery for cervical trauma in the elderly remains unclear. The aim of this study is to investigate the rates of, and factors associated with mortality and the deterioration in walking capacity occurring 1 year after spinal fusion surgery for cervical fractures in patients 65 years of age or older.

Methods: Three hundred thirteen patients aged 65 years or more with a traumatic cervical fracture who received spinal fusion surgery were enrolled. The patients were divided into a survival group and a mortality group, or a maintained walking capacity group and a deteriorated walking capacity group. We compared patients' backgrounds, trauma, and surgical parameters between the two groups. To identify factors associated with mortality or a deteriorated walking capacity 1 year postoperatively, a multivariate logistic regression analysis was conducted.

Results: One year postoperatively, the rate of mortality was 8%. A higher Charlson comorbidity index (CCI) score, a more severe the American Spinal Cord Injury Association impairment scale (AIS), and longer surgical time were identified as independent factors associated with an increase in 1-year mortality. The rate of deterioration in walking capacity between pre-trauma and 1 year postoperatively was 33%. A more severe AIS, lower albumin (Alb) and hemoglobin (Hb) values, and a larger number of fused segments were identified as independent factors associated with the increased risk of deteriorated walking capacity 1 year postoperatively.

Conclusions: The 1-year rate of mortality after spinal fusion surgery for cervical fracture in patients 65 years of age or older was 8%, and its associated factors were a higher CCI score, a more severe AIS, and a longer surgical time. The rate of deterioration in walking capacity was 33%, and its associated factors were a more severe AIS, lower Alb, lower Hb values, and a larger number of fused segments.

Keywords: Cervical fracture; Elderly; Mortality; Spinal fusion surgery; Walking capacity.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

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