{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:59:08Z","timestamp":1790355548510,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,8,12]],"date-time":"2015-08-12T00:00:00Z","timestamp":1439337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Fatal cervical spinal cord injury (<jats:styled-content style=\"fixed-case\">SCI<\/jats:styled-content>) associated with collapse of the circulatory and\/or respiratory system usually consists of high cervical <jats:styled-content style=\"fixed-case\">SCI<\/jats:styled-content> caused by high\u2010energy trauma. As the elderly population grows, however, the etiology of fatal <jats:styled-content style=\"fixed-case\">SCI<\/jats:styled-content> may be changing. The aim of the present study was to understand the current clinical features of fatal <jats:styled-content style=\"fixed-case\">SCI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis was performed on 73 consecutive patients with acute cervical <jats:styled-content style=\"fixed-case\">SCI<\/jats:styled-content> between 2007 and 2013. Fourteen (19%) of them presented in a state of coma due to severe circulatory collapse after cardiac arrest (<jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>, <jats:italic>n<\/jats:italic>\u2009=\u200911) or respiratory arrest (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, <jats:italic>n<\/jats:italic>\u2009=\u20093), and were resuscitated at the scene or hospital. The clinical features and radiological findings of these 14 patients were compared with those of the other 59.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven of the 14 fatal <jats:styled-content style=\"fixed-case\">SCI<\/jats:styled-content> patients were injured by minor traumas. Computed tomography revealed <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>1\u20102 fractures or dislocations in 11 patients and subaxial injuries in three patients. Eleven patients showed some kind of ossification of the spinal column ligaments. In a univariate analysis, the predictive factors associated with fatal circulatory collapse were age (<jats:italic>P<\/jats:italic>\u2009=\u20090.02), estimated <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>1\/2 injury (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), and complete tetraplegia (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). In a multiple regression model for fatality, the odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) for <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>1\/2 injury and <jats:styled-content style=\"fixed-case\">ASIA<\/jats:styled-content> impairment score (<jats:styled-content style=\"fixed-case\">AIS<\/jats:styled-content>) A were 20.58 (<jats:italic>P<\/jats:italic>\u2009=\u20090.006) and 151.97 (<jats:italic>P<\/jats:italic>\u2009=\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A state of unconsciousness with fatal circulatory collapse was significantly associated with <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>1\/2 injury and <jats:styled-content style=\"fixed-case\">AIS A<\/jats:styled-content>. Moreover, our data show that fatal <jats:styled-content style=\"fixed-case\">SCI<\/jats:styled-content> can occur due to minor trauma in elderly people.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.142","type":"journal-article","created":{"date-parts":[[2015,8,12]],"date-time":"2015-08-12T11:22:08Z","timestamp":1439378528000},"page":"86-93","source":"Crossref","is-referenced-by-count":6,"title":["Cervical spinal cord injuries associated with resuscitation from fatal circulatory collapse"],"prefix":"10.1002","volume":"3","author":[{"given":"Kei","family":"Miyata","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Sapporo Medical University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izumi","family":"Koyanagi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hokkaido Neurosurgical Hokkaido Neurosurgical Memorial Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Mikuni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Sapporo Medical University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eichi","family":"Narimatsu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Sapporo Medical University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1981.54.3.0316"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198611000-00002"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000196673.58429.2a"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198709000-00005"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1038\/sj.sc.3101975","article-title":"Complete medulla\/cervical spinal cord transection after atlanto\u2010occipital dislocation: an extraordinary case","volume":"45","author":"Gautschi OP","year":"2007","journal-title":"Spinal Cord"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318182272a"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199908000-00016"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3102008"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90179-1"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181f49718"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.65.8.1126"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200101000-00021"},{"key":"e_1_2_9_14_1","first-page":"75","article-title":"Geriatric trauma patients with cervical spine fractures due to ground level fall: five years experience in a level one trauma center","volume":"5","author":"Wang H","year":"2013","journal-title":"J. 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