Effect of Early vs Delayed Surgical Treatment on Motor Recovery in Incomplete Cervical Spinal Cord Injury With Preexisting Cervical Stenosis: A Randomized Clinical Trial.

Importance: The optimal management for acute traumatic cervical spinal cord injury (SCI) is unknown.

Objective: To determine whether early surgical decompression results in better motor recovery than delayed surgical treatment in patients with acute traumatic incomplete cervical SCI associated with preexisting canal stenosis but without bone injury.

Design, Setting, And Participants: This multicenter randomized clinical trial was conducted in 43 tertiary referral centers in Japan from December 2011 through November 2019.

A retro-odontoid pseudotumor treated with fixation and tumor resection by the lateral approach: illustrative case.

Background: A retro-odontoid pseudotumor is not a condition that requires resection. However, pathological diagnosis is required when a tumor such as a meningeal tumor or chordoma is suspected. The authors report a case of a large lesion treated with posterior fixation and tumor resection using a lateral approach.

A nationwide survey on the incidence and characteristics of traumatic spinal cord injury in Japan in 2018.

Study Design: Retrospective epidemiological study.

Objectives: Since the causes and incidences of traumatic spinal cord injury (TSCI) in each country change over time, up-to-date epidemiological studies are required for countermeasures against TSCI. However, no nationwide survey in Japan has been conducted for about 30 years.

Minimally Invasive Cervical Pedicle Screw Fixation (MICEPS) via a Posterolateral Approach.

Cervical pedicle screw (PS) fixation provides great mechanical strength; however, it needs wide soft tissue detachment and has vertebral artery damage risk. Minimally invasive cervical pedicle screw (MICEPS) fixation, a new method for cervical PS fixation through a posterolateral approach, was developed to reduce soft tissue damage and avoid lateral misplacement of screws. Sixty-seven patients with cervical injury underwent MICEPS fixation.

Minimally invasive cervical pedicle screw fixation via the posterolateral approach for metastatic cervical spinal tumors.

Background: To avoid lateral misplacement of midcervical pedicle screws, we developed a method for Minimally Invasive Cervical Pedicle Screw (MICEPS) fixation via a posterolateral approach. This intramuscular approach allows for horizontal pedicle screw insertion and reduced intraoperative bleeding. We reviewed our initial experience with MICEPS fixation for patients with cervical metastases.

Early predictors for massive transfusion in older adult severe trauma patients.

Background: Many scoring systems for the early prediction of the need for massive transfusion (MT) have been reported; in most of these, vital signs are regarded as important. However, the validity of these scoring systems in older patients remains unclear because older trauma patients often present with normal vital signs. In this study, we investigated the effectiveness of previously described scoring systems, as well as risk factors that can provide early prediction of the need for MT in older severe trauma patients.

Minimally Invasive Cervical Pedicle Screw Fixation by a Posterolateral Approach for Acute Cervical Injury.

Study Design: This is a retrospective case series.

Objective: To avoid lateral misplacement of midcervical pedicle screws, T.T.

Bleeding sites in elderly trauma patients who required massive transfusion: a comparison with younger patients.

Introduction: Among elderly patients with severe trauma, the sites of massive hemorrhage and their clinical characteristics are not well understood. Therefore, we investigated the sites of massive hemorrhage in patients with severe trauma, and compared the results for younger and elderly patients.

Methods: A cohort of severe trauma patients (Injury Severity Score ≥16) admitted from March 2007 to December 2014 was reviewed retrospectively.

Admission fibrinogen levels in severe trauma patients: A comparison of elderly and younger patients.

Introduction: Acute coagulopathy of trauma has been much discussed recently. However, the changes in coagulation markers after trauma in the elderly are unknown. Furthermore, the baseline fibrinogen level is high in elderly patients, and the question remains as to whether fibrinogen levels also decrease early and the degree of decrease in elderly trauma patients.