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. 2019 Apr 11;14(1):98.
doi: 10.1186/s13018-019-1115-z.

Progression of local kyphosis after conservative treatment for compressive cervical spine fracture with spinal cord injury


Progression of local kyphosis after conservative treatment for compressive cervical spine fracture with spinal cord injury

Kazuya Yokota et al. J Orthop Surg Res. .


Introduction: Compressive-flexion type cervical spine fracture is typically accompanied by apparent dislocation of the facet joints, undesirable cervical alignment, and devastating neurological dysfunction, which provides strong rationale for rendering prompt operative treatment. However, the validity of conservative treatment for compressive-flexion cervical spine injury in cases with preserved congruity of the facet joints has yet to be elucidated. The purpose of this study is to evaluate the long-term outcome of cervical alignment following conservative treatment for compressive-flexion cervical spine injury with preserved congruity of the facet joints.

Methods: A total of 662 patients who experienced spinal cord injury from 2007 to 2017 were included and underwent retrospective review in a single institute. Thirteen patients were identified as receiving conservative therapy following compressive-flexion cervical spine fractures with spinal cord injury. Clinical and radiological results were collected, including vertical fractures of the vertebral column, laminar fractures, progression of local kyphosis, and neurological status. The degree of the local cervical kyphosis was evaluated with two methods: the posterior tangent method and the endplate method.

Results: All 13 patients were male, and the mean age at the time of injury was 28.4 years. The mean follow-up period was 3 years. Although none of the patients presented neurological deterioration after the injury, the degree of local kyphosis was increased at the time of final follow-up compared to what was observed at the time of injury. Patient age at the time of injury and concurrent vertical fracture of vertebral body could have been influencing factors for the progression of the kyphosis. While laminar fracture affected the kyphosis at the time of injury, it was not a strong influencing factor of the overall progression of local kyphosis.

Conclusions: The conservative option for the compressive-flexion cervical injury allowed us to treat without exacerbating neurological symptoms as long as the facet joints are preserved. However, in terms of cervical alignment, surgical stabilization may have been desirable for these patients. Notably, the younger patients and the patients with vertical fracture of the cervical vertebral column in this type of injury required closer observation to help prevent the progression of local kyphosis.

Keywords: Cervical spinal cord injury; Laminar fracture; Local kyphosis; Vertebral fracture.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Ethical Review Board of Japan Labor Health and Welfare Organization Spinal Injuries Center. We had all the necessary consent from the patients involved in the study, including consent to participate in the study where appropriate.

Consent for publication

Written informed consent for publication of their clinical details and/or clinical images was obtained from the patient.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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. 2019 Nov;57(11):960-965.
doi: 10.1038/s41393-019-0306-0. Epub 2019 Jun 14.

The EQ-5D-5L in patients admitted to a hospital in Japan with recent spinal cord injury: a descriptive study


The EQ-5D-5L in patients admitted to a hospital in Japan with recent spinal cord injury: a descriptive study

Ryuichiro Koga et al. Spinal Cord. 2019 Nov.


Study design: Descriptive study.

Objective: To demonstrate Euro Quality of Life 5-dimensional 5-level (EQ-5D-5L) by severity level at the acute stage and discharge in patients with traumatic spinal cord injury (SCI).

Setting: Spinal Injuries Center, Fukuoka, Japan.

Methods: Patients with traumatic SCI who completed the EQ-5D-5L instrument at the acute stage and discharge were divided into four groups according to severity (severity group G1; C1-C4 ASIA Impairment Scale (AIS) A, B, and C, G2; C5-C8 AIS A, B, and C, G3; T1-S5 AIS A, B, and C, G4; all AIS D). All data were extracted from the Japan single-center study for spinal cord injury database (JSSCI-DB).

Results: Data were collected from 139 individuals at the acute stage and 164 individuals at discharge. In the comparison of utility score by severity in acute stage and discharge, G3 was significantly higher in discharge (0.325 versus 0.580). Utility scores by degree of severity were significantly higher in group G4 than those of G1, G2, and G3 at the acute stage. Utility scores at discharge were significantly higher in groups G3 and G4 than in G1, and there was a significant difference between groups G4 and G2.

Conclusions: At each stage, the utility scores of group G4 were significantly higher than those of groups G1 and G2. Altogether, the utility scores for hospitalized patients with traumatic SCI that were indicated in this study will serve as basic data that can be used while performing spinal regeneration medical procedures in the future.

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