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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Operative Outcomes After Cervical Diffuse Idiopathic Skeletal Hyperostosis Fracture in the Elderly
Alp Ozpinar1,2, Jennifer L Perez3, Emily Hacker3
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
International Journal of Spine Surgery
|June 30, 2022
Summary
Elderly patients with cervical diffuse idiopathic skeletal hyperostosis (DISH) fractures face high risks. Poorer ASIA and higher ASA/SLIC scores predict worse outcomes and mortality.
Area of Science:
- Orthopedic surgery
- Geriatric trauma
- Spinal fracture management
Background:
- Cervical diffuse idiopathic skeletal hyperostosis (DISH) fractures are unstable, posing risks of neurologic injury and death.
- Elderly patients (>70 years) with comorbidities are most affected by these fractures.
Purpose of the Study:
- To assess factors influencing outcomes in elderly patients with cervical DISH fractures.
- Identify predictors of 30-day mortality and discharge ambulatory status.
Main Methods:
- Retrospective multi-institutional cohort study of elderly patients (2008-2017).
- Analysis of injury level, surgical approach, comorbidities, ASA, ASIA, anticoagulation, and SLIC scores.
- Univariate and multivariate analyses for outcome prediction.
Main Results:
- 48 elderly patients (mean age 74.7) underwent cervical fixation.
- Higher SLIC scores correlated with increased 30-day mortality.
- Poorer ASIA grade and ASA score >3 predicted nonambulatory status at discharge.
Conclusions:
- Cervical DISH fractures require surgical fixation due to instability.
- Preoperative ASIA grade, SLIC score, and ASA score are crucial for surgical decision-making and outcome prediction.
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