{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T04:54:29Z","timestamp":1791003269550,"version":"4.1.0"},"reference-count":29,"publisher":"Japanese Society for Spine Surgery and Related Research","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Spine Surg Relat Res"],"published-print":{"date-parts":[[2026,9,27]]},"DOI":"10.22603\/ssrr.2026-0064","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:09:57Z","timestamp":1782166197000},"page":"693-701","source":"Crossref","is-referenced-by-count":0,"title":["Neurological Recovery Trajectories in Older Patients with Cervical Spinal Cord Injury: A Multicenter Longitudinal Study"],"prefix":"10.22603","volume":"10","author":[{"given":"Ryosuke","family":"Hirota","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Sapporo Medical University"},{"name":"Department of Neurology, Yale University School of Medicine, New Haven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Terashima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sapporo Medical University"},{"name":"Department of Orthopaedic Surgery, Matsuda Orthopedic Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Emori","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sapporo Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Teramoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sapporo Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Yokogawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Sasagawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University"},{"name":"Department of Orthopedics Surgery, Toyama Prefectural Central Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nakashima","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Nagoya University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Segi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Nagoya University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadayuki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Nagoya University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Funayama","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiko","family":"Eto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Yamaji","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Nori","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine"},{"name":"Department of Orthopaedic Surgery, Japanese Red Cross Shizuoka Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Furuya","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Yunde","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hamamatsu University School of Medicine"},{"name":"Department of Orthopaedic Surgery, Nagoya Kyoritsu Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hamamatsu University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuaki","family":"Imajo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Ikegami","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Uehara","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Tonomura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munehiro","family":"Sakata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine"},{"name":"Department of Orthopaedics, Saiseikai Shiga Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Onoda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Uei","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nihon University Hospital"},{"name":"Department of Orthopedic Surgery, Nihon University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokatsu","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Nihon University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Misaki","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetomi","family":"Terai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Tamai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyoshi","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kitasato University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gen","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kitasato University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Iizuka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Takasawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Akeda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mie University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiko","family":"Takegami","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mie University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruki","family":"Funao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare"},{"name":"Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital"},{"name":"Department of Orthopaedic Surgery and Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Tokyo Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kaito","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshitaka","family":"Yoshii","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Institute of Science Tokyo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Seki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Imagama","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medicine, Nagoya University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"9891","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1. Dietz V, Fouad K. Restoration of sensorimotor functions after spinal cord injury. Brain. 2014;137 (3):654-67.","DOI":"10.1093\/brain\/awt262"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Samuel AM, Bohl DD, Basques BA, et al. Analysis of delays to surgery for cervical spinal cord injuries. Spine. 2015;40 (13):992-1000.","DOI":"10.1097\/BRS.0000000000000883"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Finnerup NB, Attal N, Haroutounian S, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015;14 (2):162-73.","DOI":"10.1016\/S1474-4422(14)70251-0"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Kirshblum S, Snider B, Eren F, et al. Characterizing natural recovery after traumatic spinal cord injury. J Neurotrauma. 2021;38 (9):1267-84.","DOI":"10.1089\/neu.2020.7473"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Miyakoshi N, Suda K, Kudo D, et al. A nationwide survey on the incidence and characteristics of traumatic spinal cord injury in Japan in 2018. Spinal Cord. 2021;59 (6):626-34.","DOI":"10.1038\/s41393-020-00533-0"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Jain NB, Ayers GD, Peterson EN, et al. Traumatic spinal cord injury in the United States, 1993-2012. JAMA. 2015;313 (22):2236-43.","DOI":"10.1001\/jama.2015.6250"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7. Yokogawa N, Kato S, Sasagawa T, et al. Differences in clinical characteristics of cervical spine injuries in older adults by external causes: a multicenter study of 1512 cases. Sci Rep. 2022;12 (1):15867.","DOI":"10.1038\/s41598-022-19789-y"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Uehara M, Ikegami S, Takizawa T, et al. Is blood loss greater in elderly patients under antiplatelet or anticoagulant medication for cervical spine injury surgery? A Japanese multicenter survey. Spine Surg Relat Res. 2021;6 (4):366-72.","DOI":"10.22603\/ssrr.2021-0183"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9. Sasagawa T, Yokogawa N, Hayashi H, et al. A multicenter study of 1-year mortality and walking capacity after spinal fusion surgery for cervical fracture in elderly patients. BMC Musculoskelet Disord. 2022;23 (1):798.","DOI":"10.1186\/s12891-022-05752-5"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10. Nori S, Watanabe K, Takeda K, et al. Does surgery improve neurological outcomes in older individuals with cervical spinal cord injury without bone injury? A multicenter study. Spinal Cord. 2022;60 (10):895-902.","DOI":"10.1038\/s41393-022-00818-6"},{"key":"11","unstructured":"11. Nakajima H, Yokogawa N, Sasagawa T, et al. Prognostic factors for cervical spinal cord injury without major bone injury in elderly patients. J Neurotrauma. 2022;39 (9-10):658-66."},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Hirota R, Terashima Y, Ohnishi H, et al. Prognostic factors for respiratory dysfunction for cervical spinal cord injury and\/or cervical fractures in elderly patients: a multicenter survey. Global Spine J. 2024;14 (1):101-12.","DOI":"10.1177\/21925682221095470"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Hirota R, Terashima Y, Ohnishi H, et al. Prognostic impact of respiratory dysfunction in elderly patients with cervical spinal cord injury and\/or fractures: a multicenter survey. Eur Spine J. 2023;32 (10):3522-32.","DOI":"10.1007\/s00586-023-07828-9"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Kobayashi M, Yokogawa N, Kato S, et al. Risk factors for early mortality in older patients with traumatic cervical spine injuries-a multicenter retrospective study of 1512 cases. J Clin Med. 2023;12 (2):708.","DOI":"10.1016\/j.bas.2022.101071"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15. van Middendorp JJ, Hosman AJF, Donders ART, et al. A clinical prediction rule for ambulation outcomes after traumatic spinal cord injury: a longitudinal cohort study. Lancet. 2011;377 (9770):1004-10.","DOI":"10.1016\/S0140-6736(10)62276-3"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Kirshblum SC, Burns SP, Biering-Sorensen F, et al. International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011;34 (6):535-46.","DOI":"10.1179\/204577211X13207446293695"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Schuld C, EMSCI study group, Kirshblum S, et al. The revised zone of partial preservation (ZPP) in the 2019 International Standards for Neurological Classification of Spinal Cord Injury: ZPP applicability in incomplete injuries. Spinal Cord. 2024;62 (2):79-87.","DOI":"10.1038\/s41393-023-00950-x"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Fawcett JW, Curt A, Steeves JD, et al. Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials. Spinal Cord. 2007;45 (3):190-205.","DOI":"10.1038\/sj.sc.3102007"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. Curt A, Van Hedel HJA, Klaus D, et al. Recovery from a spinal cord injury: significance of compensation, neural plasticity, and repair. J Neurotrauma. 2008;25 (6):677-85.","DOI":"10.1089\/neu.2007.0468"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Steeves JD, Kramer JK, Fawcett JW, et al. Extent of spontaneous motor recovery after traumatic cervical sensorimotor complete spinal cord injury. Spinal Cord. 2011;49 (2):257-65.","DOI":"10.1038\/sc.2010.99"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Marino RJ, Burns S, Graves DE, et al. Upper- and lower-extremity motor recovery after traumatic cervical spinal cord injury: an update from the National Spinal Cord Injury Database. Arch Phys Med Rehabil. 2011;92 (3):369-75.","DOI":"10.1016\/j.apmr.2010.09.027"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Marino RJ, Ditunno JF Jr, Donovan WH, et al. Neurologic recovery after traumatic spinal cord injury: data from the Model Spinal Cord Injury Systems. Arch Phys Med Rehabil. 1999;80 (11):1391-6.","DOI":"10.1016\/S0003-9993(99)90249-6"},{"key":"23","doi-asserted-by":"crossref","unstructured":"23. Coleman WP, Geisler FH. Injury severity as primary predictor of outcome in acute spinal cord injury: retrospective results from a large multicenter clinical trial. Spine J. 2004;4 (4):373-8.","DOI":"10.1016\/j.spinee.2003.12.006"},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Seel RT, Huang ME, Cifu DX, et al. Age-related differences in length of stays, hospitalization costs, and outcomes for an injury-matched sample of adults with paraplegia. J Spinal Cord Med. 2001;24 (4):241-50.","DOI":"10.1080\/10790268.2001.11753581"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Jakob W, Wirz M, van Hedel HJA, et al. Difficulty of elderly SCI subjects to translate motor recovery\u2014 &quot;body function&quot; \u2014into daily living activities. J Neurotrauma. 2009;26 (11):2037-44.","DOI":"10.1089\/neu.2008.0824"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Furlan JC, Bracken MB, Fehlings MG. Is age a key determinant of mortality and neurological outcome after acute traumatic spinal cord injury? Neurobiol Aging. 2010;31 (3):434-46.","DOI":"10.1016\/j.neurobiolaging.2008.05.003"},{"key":"27","doi-asserted-by":"crossref","unstructured":"27. Kramer JLK, Lammertse DP, Schubert M, et al. Relationship between motor recovery and independence after sensorimotor-complete cervical spinal cord injury. Neurorehabil Neural Repair. 2012;26 (9):1064-71.","DOI":"10.1177\/1545968312447306"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28. Kirshblum SC, Botticello AL, Dyson-Hudson TA, et al. Patterns of sacral sparing components on neurologic recovery in newly injured persons with traumatic spinal cord injury. Arch Phys Med Rehabil. 2016;97 (10):1647-55.","DOI":"10.1016\/j.apmr.2016.02.012"},{"key":"29","doi-asserted-by":"crossref","unstructured":"29. Evaniew N, Sharifi B, Waheed Z, et al. The influence of neurological examination timing within hours after acute traumatic spinal cord injuries: an observational study. Spinal Cord. 2020;58 (2):247-54.","DOI":"10.1038\/s41393-019-0359-0"}],"container-title":["Spine Surgery and Related Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/ssrr\/10\/5\/10_2026-0064\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T04:39:51Z","timestamp":1791002391000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/ssrr\/10\/5\/10_2026-0064\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,27]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.22603\/ssrr.2026-0064","relation":{},"ISSN":["2432-261X"],"issn-type":[{"value":"2432-261X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,27]]},"article-number":"2026-0064"}}