' '
Deutsch | English    

Forschungsdatenbank PMU-SQQUID

Cervical spine trauma in diffuse idiopathic skeletal hyperostosis: injury characteristics and outcome with surgical treatment.
Bransford, RJ; Koller, H; Caron, T; Zenner, J; Hitzl, W; Tomasino, A; Mayer, M;
Spine (Phila Pa 1976). 2012; 37(23): 19-32.
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Hitzl Wolfgang
Koller Heiko
Mayer Michael

Abstract

STUDY DESIGN
Retrospective study of a consecutive series of operatively managed patients with cervical fractures with diffuse idiopathic skeletal hyperostosis (DISH) presenting to 3 institutions over an 8 year period.
Assess demographics, fracture characteristics, outcome and complications in patients managed surgically.
Cervical spine injuries related to DISH represent a difficult subgroup of trauma patients to treat. This subset is fraught with potential complications related to the injury of the ankylosed spine, high rate of co-morbidities, and older demographics. The data in the literature on treatment, outcomes and complications is largely comprised of case reports and small case series.
All patients with cervical fractures in the setting of DISH between January 2001 and December 2008 were reviewed retrospectively. Charts and radiographs were reviewed assessing demographics, injury characteristics and short-term outcomes. Statistical analysis was performed analyzing the impact of distinct parameters on the incidence of medical and surgical complications.
Thirty-three patients with age 73.8 ± 11 years were identified. DISH-affected segments numbered 5.5 ± 2.1. Injury severity as assessed by the Subaxial-Injury-Classification scoring-system (SLIC) averaged 7.2 ± 1.4 points. 7 patients (20.6%) were ASIA-A on admission, 4 (11.8%) ASIA-B, 4 (11.8%) ASIA-C, 10 (29.4%) ASIA-D, and 7 (20.6%) ASIA-E. All but 2 patients (6%) had medical co-morbidities. Inpatient stay was 26.6 ± 23.4 days. 16 patients (47%) had anterior, 12 patients (35.3%) had posterior, and 5 patients (14.7%) had combined anterior-posterior instrumented fusion. 25 patients (73.5%) had medical/surgical complications. 20 patients (58.8%) suffered serious pulmonary complications not related to the neurologic injury (p < 0.05). Nine patients (26.5%) had died. Seven patients (20.6%) showed improved ASIA-scores, 18 patients (52.9%) had no improvement and 2 patients (5.9%) deteriorated.
The current findings pinpoint the potential for medical and surgical complications in this high risk subgroup. Surgeons should be aware of the unique aspects associated with treatment of these injuries.


Useful keywords (using NLM MeSH Indexing)

Aged

Aged, 80 and over

Analysis of Variance

Austria

Cervical Vertebrae/injuries

Cervical Vertebrae/radiography

Cervical Vertebrae/surgery*

Chi-Square Distribution

Comorbidity

Female

Humans

Hyperostosis, Diffuse Idiopathic Skeletal/complications*

Hyperostosis, Diffuse Idiopathic Skeletal/mortality

Hyperostosis, Diffuse Idiopathic Skeletal/radiography

Injury Severity Score

Length of Stay

Lung Diseases/etiology

Male

Middle Aged

New York City

Retrospective Studies

Risk Factors

Spinal Fractures/etiology

Spinal Fractures/mortality

Spinal Fractures/radiography

Spinal Fractures/surgery*

Spinal Fusion*/adverse effects

Spinal Fusion*/mortality

Time Factors

Treatment Outcome

Washington


Find related publications in this database (Keywords)

DISH
diffuse idiopathic skeletal hyperostosis
ankylosed spine
fracture