{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:35:54Z","timestamp":1792715754919,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T00:00:00Z","timestamp":1538956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of our study was to identify the demographics and complications in elderly cervical spine injuries and predictive factors for surgery, complications and mortality. We hypothesized younger healthier patients were more likely to undergo surgical intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of 225 consecutive patients aged 65\u2009years and over with cervical spine injuries was carried out over a 3\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 113 males and 112 females with an average of 79.7 years (range 65\u201398). The most common fracture was C2 peg type (21.8%). Five patients had complete spinal cord injury (2.2%), 25 had incomplete spinal cord injury (11.1%) and 84% were neurologically intact. Fifty\u2010four patients were managed operatively (24%), while 171 patients were managed non\u2010operatively (76%). The operative group had higher rates of pneumonia (odds ratio (OR) 5.3, 95% confidence interval (CI) 2.6\u201310.7, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), cardiac arrhythmia (OR 4.1, 95% CI 1.5\u201311.2, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) and respiratory failure (OR 2.6, 95% CI 1.2\u20135.5, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). There was no difference in mortality between the operative and non\u2010operative group (18.5% and 12.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.3). Patients with complete spinal cord injury had 100% mortality. Significant predictive factors for complications and death were neurological deficits, comorbidities and the presence of other injuries (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Surgery was not predictive for death and the operative group was younger than the non\u2010operative group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the setting of a high complication rate, consideration should be given to palliation in elderly patients with complete spinal cord injury and there must be good rational for surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.14875","type":"journal-article","created":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T08:39:17Z","timestamp":1538987957000},"page":"412-417","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Morbidity and mortality in cervical spine injuries in the elderly"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4900-5043","authenticated-orcid":false,"given":"Ali R.","family":"Bokhari","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brahman","family":"Sivakumar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Sefton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juin\u2010Lih","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randolph","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Hartin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000174671.07664.7c"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199809010-00006"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.178.3.1780573"},{"key":"e_1_2_7_5_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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