Spine Surgery and Related Research (Nov 2024)
Is Intraoperative Blood Loss Volume in Elderly Cervical Spine Injury Surgery Greater in Patients with Ankylosis? A Multicenter Survey
- Masashi Uehara,
- Shota Ikegami,
- Takashi Takizawa,
- Hiroki Oba,
- Noriaki Yokogawa,
- Takeshi Sasagawa,
- Hiroaki Nakashima,
- Naoki Segi,
- Sadayuki Ito,
- Toru Funayama,
- Fumihiko Eto,
- Akihiro Yamaji,
- Kota Watanabe,
- Satoshi Nori,
- Kazuki Takeda,
- Takeo Furuya,
- Atsushi Yunde,
- Hideaki Nakajima,
- Tomohiro Yamada,
- Tomohiko Hasegawa,
- Yoshinori Terashima,
- Ryosuke Hirota,
- Hidenori Suzuki,
- Yasuaki Imajo,
- Hitoshi Tonomura,
- Munehiro Sakata,
- Ko Hashimoto,
- Yoshito Onoda,
- Kenichi Kawaguchi,
- Yohei Haruta,
- Nobuyuki Suzuki,
- Kenji Kato,
- Hiroshi Uei,
- Hirokatsu Sawada,
- Kazuo Nakanishi,
- Kosuke Misaki,
- Hidetomi Terai,
- Koji Tamai,
- Akiyoshi Kuroda,
- Gen Inoue,
- Kenichiro Kakutani,
- Yuji Kakiuchi,
- Katsuhito Kiyasu,
- Hiroyuki Tominaga,
- Hiroto Tokumoto,
- Yoichi Iizuka,
- Eiji Takasawa,
- Koji Akeda,
- Norihiko Takegami,
- Haruki Funao,
- Yasushi Oshima,
- Takashi Kaito,
- Daisuke Sakai,
- Toshitaka Yoshii,
- Tetsuro Ohba,
- Bungo Otsuki,
- Shoji Seki,
- Masashi Miyazaki,
- Masayuki Ishihara,
- Seiji Okada,
- Shiro Imagama,
- Satoshi Kato
Affiliations
- Masashi Uehara
- Department of Orthopaedic Surgery, Shinshu University School of Medicine
- Shota Ikegami
- Department of Orthopaedic Surgery, Shinshu University School of Medicine
- Takashi Takizawa
- Department of Orthopaedic Surgery, Shinshu University School of Medicine
- Hiroki Oba
- Department of Orthopaedic Surgery, Shinshu University School of Medicine
- Noriaki Yokogawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University
- Takeshi Sasagawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University
- Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University, Graduate School of Medicine
- Naoki Segi
- Department of Orthopedic Surgery, Nagoya University, Graduate School of Medicine
- Sadayuki Ito
- Department of Orthopedic Surgery, Nagoya University, Graduate School of Medicine
- Toru Funayama
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba
- Fumihiko Eto
- Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba
- Akihiro Yamaji
- Department of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital
- Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine
- Satoshi Nori
- Department of Orthopaedic Surgery, Keio University School of Medicine
- Kazuki Takeda
- Department of Orthopaedic Surgery, Keio University School of Medicine
- Takeo Furuya
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
- Atsushi Yunde
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
- Hideaki Nakajima
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui
- Tomohiro Yamada
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine
- Tomohiko Hasegawa
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine
- Yoshinori Terashima
- Department of Orthopaedic Surgery, Sapporo Medical University
- Ryosuke Hirota
- Department of Orthopaedic Surgery, Sapporo Medical University
- Hidenori Suzuki
- Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine
- Yasuaki Imajo
- Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine
- Hitoshi Tonomura
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
- Munehiro Sakata
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
- Ko Hashimoto
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
- Yoshito Onoda
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine
- Kenichi Kawaguchi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University
- Yohei Haruta
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University
- Nobuyuki Suzuki
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences
- Kenji Kato
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences
- Hiroshi Uei
- Department of Orthopaedic Surgery, Nihon University Hospital
- Hirokatsu Sawada
- Department of Orthopaedic Surgery, Nihon University School of Medicine
- Kazuo Nakanishi
- Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School
- Kosuke Misaki
- Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School
- Hidetomi Terai
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine
- Koji Tamai
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine
- Akiyoshi Kuroda
- Department of Orthopaedic Surgery, Kitasato University School of Medicine
- Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University School of Medicine
- Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine
- Yuji Kakiuchi
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine
- Katsuhito Kiyasu
- Department of Orthopaedic Surgery, Kochi Medical School, Kochi University
- Hiroyuki Tominaga
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
- Hiroto Tokumoto
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University
- Yoichi Iizuka
- Department of Orthopaedic Surgery, Gunma University, Graduate School of Medicine
- Eiji Takasawa
- Department of Orthopaedic Surgery, Gunma University, Graduate School of Medicine
- Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine
- Norihiko Takegami
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine
- Haruki Funao
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare
- Yasushi Oshima
- Department of Orthopaedic Surgery, The University of Tokyo Hospital
- Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine
- Daisuke Sakai
- Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine
- Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University
- Tetsuro Ohba
- Department of Orthopaedic Surgery, University of Yamanashi
- Bungo Otsuki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University
- Shoji Seki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama
- Masashi Miyazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, Oita University
- Masayuki Ishihara
- Department of Orthopaedic Surgery, Kansai Medical University Hospital
- Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine
- Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University, Graduate School of Medicine
- Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University
- DOI
- https://doi.org/10.22603/ssrr.2023-0118
- Journal volume & issue
-
Vol. 8,
no. 6
pp. 575 – 582
Abstract
Introduction: Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury. Methods: The case histories of 1512 patients with cervical spine injury at among 33 institutions were reviewed. After the exclusion of patients without surgery or whose blood loss or ankylosis status was unclear, 793 participants were available for analysis. Differences in blood loss volume were compared between the Ankylosis (+) group with ankylosis at the cervical level and the Ankylosis (−) group without by the inverse probability of treatment weighting (IPTW) method using a propensity score. Results: Of the 779 patients (mean age: 75.0±6.3 years) eligible for IPTW calculation, 257 (32.4%) had ankylosis at the cervical level. The mean blood loss volume was higher in Ankylosis (+) patients than in Ankylosis (−) patients (P<0.001). This difference did not reach statistical significance when weighted by background factors, with mean blood loss of 244 mL and 188 mL, respectively, after adjustment. Conclusions: This study revealed that ankylosis was significantly associated with increased blood loss volume when unadjusted by surgical time. Elderly patients with cervical spine injury accompanied by ankylosis appear predisposed to higher bleeding and severe hemorrhage, both as a result of the condition and their particular demographic characteristics.
Keywords
- cervical spine injury
- elderly patients
- blood loss volume
- ossification of the posterior longitudinal ligament
- ossification of the ligamentum flavum
- diffuse idiopathic skeletal hyperostosis
