Prognosis of Cervical Diffuse Idiopathic Skeletal Hyperostosis-Related Spine Injuries in Elderly Patients: Analyses of Both Fracture and Spinal Cord Injury Without Fracture

Global Spine Journal, 2025 · DOI: 10.1177/21925682231186757 · Published: February 1, 2025

Simple Explanation

This study investigates the outcomes of elderly patients who experience spine injuries related to a condition called cervical Diffuse Idiopathic Skeletal Hyperostosis (cDISH). cDISH causes the bones in the neck to fuse together. The researchers compared elderly patients with cDISH-related injuries to a control group of elderly patients without cDISH to see if cDISH worsened prognosis. They looked at two types of injuries: fractures and spinal cord injuries without fractures, to see if cDISH had different impacts.

Study Duration

2010 and 2020

Participants

140 patients aged 65 years or older with cDISH-related cervical spine injuries and 1363 patients without cDISH

Evidence Level

Not specified

Key Findings

1
Elderly patients with cDISH-related spine injuries involving fractures did not show significantly different complication rates, ambulation outcomes, or paralysis severity compared to matched controls.
2
Elderly patients with cDISH-related spine injuries without fractures had significantly poorer ambulation at discharge compared to matched controls, but no significant difference at 6 months.
3
Complete paralysis and older age were identified as significant risk factors for mortality in patients with cDISH-related injuries.

Research Summary

This retrospective multicenter study analyzed 140 elderly patients with cDISH-related injuries (106 fractures, 34 SCI without fracture) compared to matched controls. Patients with cDISH-related fractures had similar outcomes to controls. Patients with cDISH-related SCI without fracture had worse ambulation at discharge but similar outcomes at 6 months. Complete paralysis and older age were significant risk factors for mortality, highlighting the need for prompt diagnosis and treatment of cDISH-related injuries.

Practical Implications

Early Diagnosis

Healthcare providers should be educated about the diagnostic difficulties of cDISH-related injuries to reduce delays in diagnosis and improve patient outcomes.

Rehabilitation Strategies

Rehabilitation programs should address the specific challenges faced by patients with cDISH, particularly those with spinal cord injuries without fractures, to improve short-term ambulation outcomes.

Risk Factor Management

Given that older age and complete paralysis are risk factors for mortality, focus on managing these factors and providing intensive care to improve survival rates.

Study Limitations

1
Retrospective nature of the study may introduce selection bias.
2
The extent of ossification in cDISH cases was not fully characterized.
3
Confirmation of sacroiliac joint findings for rigorous DISH diagnosis was not available in all cases.

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