Publications by authors named "Hiroshi Uei"
Purpose: Several risk factors for adjacent segment disease (ASD) after posterior lumbar interbody fusion (PLIF) have been reported. High pelvic incidence (PI) has been identified as risk factors for L4 anterior slip in cases of lumbar degenerative spondylolisthesis. Correcting the slip with L4-L5 fixation merely restores the lumbar alignment, but the PI itself remains unchanged.
View Article and Find Full Text PDFPurpose: Cervical spine injuries in the elderly (defined as individuals aged 65 years and older) are increasing, often resulting from falls and minor trauma. Prognosis varies widely, influenced by multiple factors. This study aimed to develop a deep-learning-based predictive model for post-injury outcomes.
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- * Out of 451 patients over 65 years with cervical fractures, 69% had mid-cervical injuries while 31% had lower-cervical injuries, with lower-cervical injuries being linked to more high-energy trauma cases.
- * Although lower-cervical injuries resulted in fewer muscle weaknesses compared to mid-cervical injuries, many patients still experienced neurological deficits and similar overall complication rates after treatment, such as respiratory issues but no significant differences in mortality or mobility outcomes.
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.
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- This study analyzed 389 patients aged 65 and older with cervical spinal cord injury (CSCI) but no bone injury to assess the effects of diabetes on neurological recovery.
- The research found that there were no significant differences in neurological outcomes between diabetic patients and those without diabetes at 6 months post-injury.
- Additionally, moderate-severe diabetes did not adversely impact recovery, suggesting that diabetic patients had similar improvements in neurological function as their nondiabetic counterparts.
Article Synopsis
- Dysphagia, a serious swallowing disorder, affects older adults post-spinal cord injury, particularly those with cervical injuries, though its risk factors are not well understood.
- A study involving 707 patients aged 65 and older identified male sex, low nutritional status (GNRI <92), dementia, fractures, complete paralysis, anterior surgery, and tracheostomy as significant risk factors for dysphagia.
- The findings suggest that a low geriatric nutritional risk index (GNRI) is a key indicator of dysphagia risk, implying that nutritional health is critical for recovery in elderly patients with cervical spinal injuries.
Article Synopsis
- - The study aimed to create and validate a rehabilitation system for dysphagia (swallowing difficulties) using information and communication technology (ICT) in older patients at risk of aspiration pneumonia.
- - Researchers compared 120 patients, with one group receiving standard rehabilitation and the other using the ICT system, which included additional evaluations and training.
- - Results showed significant improvements in swallowing function and overall independence, indicating that ICT could enhance rehabilitation in underserved areas lacking healthcare professionals.
Objective: The purpose of this study was to examine how rehabilitation and patient education for knee osteoarthritis improves health-related quality of life (HRQOL) and to identify factors influencing HRQOL.
Methods: Between May 2020 and March 2022, 30 patients with osteoarthritis of the knee were treated conservatively and rehabilitated with a patient education program. The patient education program was based on the health belief model by Sedlak et al.
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- This study examined how malnutrition affects older patients (65+) with cervical spinal cord injuries and their outcomes after treatment.
- Among 789 patients, 6% had major nutritional risks at the start, which impacted their survival and recovery.
- Results showed that those with major nutritional risks had a significantly higher death rate, shorter lifespan, less neurological improvement, and greater difficulty with daily activities a year after their injury compared to matched controls.
Article Synopsis
- The study investigated the prognosis and factors predicting neurological improvement in older patients (65+) with incomplete spinal cord injuries classified as AIS-C.
- Significant differences in age, body mass index, pre-traumatic activities of daily living, and serum albumin concentrations were found among groups based on their final neurological status.
- Approximately 64.2% of patients improved to AIS-D, with only 7.1% achieving AIS-E, indicating that while many showed some improvement, complete recovery was rare and linked to higher serum albumin levels and independent pre-injury ADL.
Study Design: Retrospective multicenter study.
Objectives: The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear.
Study Design: Retrospective multicenter study.
Objectives: To investigate the treatments of the geriatric population with hangman's fractures using a multicenter database under the Japan Association of Spine Surgeons with Ambition (JASA).
Methods: The multicenter database included data from 1512 patients.
Article Synopsis
- The study is a retrospective multicenter analysis comparing elderly patients with cervical diffuse idiopathic skeletal hyperostosis (cDISH) injuries to matched controls, focusing on those with and without fractures.
- It involved 140 patients aged 65 and older, revealing that those with fractures had similar complication rates and ambulation outcomes as controls, while nonambulatory patients without fractures had significantly poorer ambulation.
- Logistic regression highlighted complete paralysis and age as major risk factors for early mortality, with 14 patients passing away within three months of the injury.*
Purpose: To investigate the impact of early post-injury respiratory dysfunction for neurological and ambulatory ability recovery in patients with cervical spinal cord injury (SCI) and/or fractures.
Methods: We included 1,353 elderly patients with SCI and/or fractures from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were included in the respiratory dysfunction group, which was further classified into mild and severe respiratory groups based on respiratory weaning management.
Background: Despite the increasing prevalence of cervical odontoid fractures in older adults, the treatment strategy is controversial. The objectives of the current study are to investigate the prognosis and complications of cervical odontoid fractures in elderly patients and to identify factors associated with worsening of ambulation after 6 months.
Methods: This multicenter, retrospective study included 167 patients aged 65 years or older with odontoid fractures.
Article Synopsis
- - The study focuses on the increasing elderly population at high risk for delirium due to cervical trauma, aiming to create a risk score to predict delirium in patients with cervical spinal cord injury or fracture regardless of their treatment type.
- - A total of 1,512 elderly patients (aged 65+) were analyzed, and significant risk factors for delirium were identified through multivariate logistic regression, leading to a delirium risk score based on six important variables.
- - The newly developed risk score can help healthcare providers make informed decisions regarding treatment strategies, despite needing further validation with additional data, having shown a prediction accuracy area under the curve of 0.66.
(1) Introduction: Spontaneous spinal epidural hematoma (SSEH) points to hematoma within the epidural space of the spinal cord without traumatic or iatrogenic causes. (2) Case Reports: One patient showed paraplegia, numbness of both legs with acute onset, acute myelopathic signs, subsequent to back pain. Magnetic resonance imaging (MRI) showed hematoma in the posterior part of the thoracic spinal cord.
View Article and Find Full Text PDFBackground: Mesenchymal stem cells (MSCs) are known to have different differentiation potential depending on the tissue of origin. Dedifferentiated fat cells (DFATs) are MSC-like multipotent cells that can be prepared from mature adipocytes by ceiling culture method. It is still unknown whether DFATs derived from adipocytes in different tissue showed different phenotype and functional properties.
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- - The study analyzed 1512 patients aged 65 and older with cervical spine injuries, revealing that 6.3% of them had dementia, which was more common in older, mainly female patients with lower body mass index and higher frailty.
- - Patients with dementia showed worse short-term outcomes, including lower functional ability in activities of daily living (ADLs) and a higher rate of dysphagia compared to those without dementia.
- - Mortality rates were significantly higher in patients with dementia following their injuries, highlighting the adverse effects of dementia on recovery and survival in this demographic.
Although the incidence of cervical spinal cord injury (CSCI) with ossification of the posterior longitudinal ligament (OPLL) has increased in older adults, its etiology and neurological outcomes remain unknown. We identified OPLL characteristics and determined whether they influence neurological severity and improvement of CSCI in older patients. This multicenter retrospective cohort study identified 1512 patients aged ≥ 65 years diagnosed with CSCI on admission during 2010-2020.
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- * Findings show that while patients who had early surgery had worse baseline neurological conditions, they experienced a greater improvement in motor scores within six months of surgery.
- * Factors like delirium, pneumonia, and diabetes negatively affected recovery, suggesting that early surgery may be beneficial but requires more research for confirmation.
For older patients with decreased reserve function, traumatic cervical spine injuries frequently lead to early mortality. However, the prognostic factors for early mortality remain unclear. This study included patients aged ≥65 years and hospitalized for treatment of traumatic cervical spine injuries in 78 hospitals between 2010 and 2020.
View Article and Find Full Text PDFStudy Design: Retrospective multicenter study.
Objectives: To investigate changes over a 10-years period in the profile of cervical spine and spinal cord injuries among the elderly in Japan.
Methods: The current multicenter study was a retrospective analysis of inpatients aged ≥65 years, suffering cervical fracture (CF) and/or cervical spinal cord injury (CSCI).
A retrospective multicenter study. Body mass index (BMI) is recognized as an important determinant of osteoporosis and spinal postoperative outcomes; however, the specific impact of BMI on surgery for osteoporotic vertebral fractures (OVFs) remains inconclusive. This retrospective multicenter study investigated the impact of BMI on clinical outcomes following fusion surgery for OVFs.
View Article and Find Full Text PDFIntroduction: Aspiration pneumonia is the predominant form of pneumonia in the elderly. Low oral intake levels and malnutrition have been reported to be associated with increased mortality and loss of function in aspiration pneumonia. However, the relationship between start of feeding and readmission, which is associated with malnutrition and low oral intake levels, has not been reported.
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