{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T03:34:06Z","timestamp":1771040046944,"version":"3.50.1"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>This study aimed to investigate the effect of surgery within 8 hours on perioperative complications and neurological prognosis in older patients with cervical spinal cord injury by using a propensity score\u2013matched analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors included 87 consecutive patients older than 70 years who had cervical spinal cord injury and who had undergone posterior decompression and fusion surgery within 24 hours of injury. The patients were divided into two groups based on the time from injury to surgery: surgery within 8 hours (group 8 hours) and between 8 and 24 hours (group 8\u201324 hours). Following the preliminary study, the authors established a 1:1 matched model using propensity scores to adjust for baseline characteristics and neurological status on admission. Perioperative complication rates and neurological outcomes at discharge were compared between the two groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Preliminary analysis of 87 prematched patients (39 in group 8 hours and 48 in group 8\u201324 hours) revealed that the motor index score (MIS) on admission was lower for lower extremities (12.3 \u00b1 15.5 vs 20.0 \u00b1 18.6, respectively; p = 0.048), and total extremities (26.7 \u00b1 27.1 vs 40.2 \u00b1 30.6, respectively; p = 0.035) in group 8 hours. In terms of perioperative complications, group 8 hours had significantly higher rates of cardiopulmonary dysfunction (46.2% vs 25.0%, respectively; p = 0.039). MIS improvement (the difference in scores between admission and discharge) was greater in group 8 hours for lower extremities (15.8 \u00b1 12.6 vs 9.0 \u00b1 10.5, respectively; p = 0.009) and total extremities (29.4 \u00b1 21.7 vs 18.7 \u00b1 17.7, respectively; p = 0.016). Using a 1:1 propensity score\u2013matched analysis, 29 patient pairs from group 8 hours and group 8\u201324 hours were selected. There were no significant differences in baseline characteristics, neurological status on admission, and perioperative complications between the two groups, including cardiopulmonary dysfunction. Even after matching, MIS improvement was significantly greater in group 8 hours for upper extremities (13.0 \u00b1 10.9 vs 7.8 \u00b1 8.3, respectively; p = 0.045), lower extremities (14.8 \u00b1 12.7 vs 8.3 \u00b1 11.0, respectively; p = 0.044) and total extremities (27.8 \u00b1 21.0 vs 16.0 \u00b1 17.5, respectively; p = 0.026).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Results of the comparison after matching demonstrated that urgent surgery within 8 hours did not increase the perioperative complication rate and significantly improved the MIS, suggesting that surgery within 8 hours may be efficient, even in older patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.11.spine23810","type":"journal-article","created":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T01:44:49Z","timestamp":1706319889000},"page":"642-652","source":"Crossref","is-referenced-by-count":5,"title":["Effect of urgent surgery within 8 hours compared to surgery between 8 and 24 hours on perioperative complications and neurological prognosis in patients older than 70 years with cervical spinal cord injury: a propensity score\u2013matched analysis"],"prefix":"10.3171","volume":"40","author":[{"given":"Tomoaki","family":"Shimizu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido;"},{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kota","family":"Suda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoko","family":"Matsumoto Harmon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miki","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Ushirozako","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kento","family":"Inomata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido;"},{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Hokkaido;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhisa","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Takahata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norimasa","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masao","family":"Koda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Arch Phys Med Rehabil","first-page":"733","article-title":"A multicenter investigation of age-related differences in lengths of stay, hospitalization charges, and outcomes for a matched tetraplegia sample","volume":"80","author":"Cifu DX","year":"1999","unstructured":"Cifu DX, Seel RT, Kreutzer JS, McKinley WO. 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J Neurotrauma. 2021;38(9):1267\u20131284."},{"issue":"11","key":"b34","series-title":"JAMA Netw Open","first-page":"e2133604","article-title":"Effect of early vs delayed surgical treatment on motor recovery in incomplete cervical spinal cord injury with preexisting cervical stenosis: a randomized clinical trial","volume":"4","author":"Chikuda H","year":"2021","unstructured":"Chikuda H, Koyama Y, Matsubayashi Y,  Effect of early vs delayed surgical treatment on motor recovery in incomplete cervical spinal cord injury with preexisting cervical stenosis: a randomized clinical trial. 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