1
|
Yokota K, Sakai H, Kawano O, Morishita Y, Masuda M, Hayashi T, Kubota K, Ideta R, Ariji Y, Koga R, Murai S, Ifuku R, Uemura M, Kishimoto J, Watanabe H, Nakashima Y, Maeda T. Changing trends in traumatic spinal cord injury in an aging society: Epidemiology of 1152 cases over 15 years from a single center in Japan. PLoS One 2024; 19:e0298836. [PMID: 38753862 PMCID: PMC11098516 DOI: 10.1371/journal.pone.0298836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/30/2024] [Indexed: 05/18/2024] Open
Abstract
Traumatic spinal cord injury (TSCI) causes an insult to the central nervous system, often resulting in devastating temporary or permanent neurological impairment and disability, which places a substantial financial burden on the health-care system. This study aimed to clarify the up-to-date epidemiology and demographics of patients with TSCI treated at the largest SCI center in Japan. Data on all patients admitted to the Spinal Injuries Center with TSCI between May 2005 and December 2021 were prospectively collected using a customized, locally designed SCI database named the Japan Single Center Study for Spinal Cord Injury Database (JSSCI-DB). A total of 1152 patients were identified from the database. The study period was divided into the four- or five-year periods of 2005-2009, 2010-2013, 2014-2017, and 2018-2021 to facilitate the observation of general trends over time. Our results revealed a statistically significant increasing trend in age at injury. Since 2014, the average age of injury has increased to exceed 60 years. The most frequent spinal level affected by the injury was high cervical (C1-C4: 45.8%), followed by low cervical (C5-C8: 26.4%). Incomplete tetraplegia was the most common cause or etiology category of TSCI, accounting for 48.4% of cases. As the number of injuries among the elderly has increased, the injury mechanisms have shifted from high-fall trauma and traffic accidents to falls on level surfaces and downstairs. Incomplete tetraplegia in the elderly due to upper cervical TSCI has also increased over time. The percentage of injured patients with an etiology linked to alcohol use ranged from 13.2% (2005-2008) to 19% (2014-2017). Given that Japan has one of the highest aging populations in the world, epidemiological studies in this country will be very helpful in determining health insurance and medical costs and deciding strategies for the prevention and treatment of TSCI in future aging populations worldwide.
Collapse
Affiliation(s)
- Kazuya Yokota
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan
| | - Hiroaki Sakai
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Osamu Kawano
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Yuichiro Morishita
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Muneaki Masuda
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Tetsuo Hayashi
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Kensuke Kubota
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Ryosuke Ideta
- Department of Rehabilitation Medicine, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Yuto Ariji
- Department of Rehabilitation Medicine, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Ryuichiro Koga
- Department of Rehabilitation Medicine, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Satoshi Murai
- Department of Rehabilitation Medicine, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Ryusei Ifuku
- Department of Rehabilitation Medicine, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Masatoshi Uemura
- Department of Rehabilitation Medicine, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| | - Junji Kishimoto
- Center for Clinical and Translational Research, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan
| | - Hiroko Watanabe
- Center for Clinical and Translational Research, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan
| | - Takeshi Maeda
- Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, Iizuka, Fukuoka, Japan
| |
Collapse
|
2
|
Mavrovounis G, Makris M, Demetriades AK. Traumatic spinal cord and spinal column injuries: A bibliometric analysis of the 200 most cited articles. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2023; 14:346-364. [PMID: 38268681 PMCID: PMC10805157 DOI: 10.4103/jcvjs.jcvjs_97_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 01/26/2024] Open
Abstract
Study Design Bibliometric analysis. Objectives This study aimed to highlight the 200 most influential articles related to traumatic spinal cord and spinal column injuries and provide an insight of past and current global trends in spinal trauma research. Methods The Web of Science database was used to identify the top 200 most cited articles on the topic of traumatic spinal cord injury (SCI) and spinal column injuries between using a prespecified algorithm. The articles were manually reviewed; bibliometrics were collected on title, first and corresponding authors' country, institution, journal, publication year, and citation data. Results The search string yielded 30,551 articles during 1977-2019. The average time from the publication was 19.5 years. A total of 1356 authors contributed to 67 different journals, the top 200 most cited articles amassing a total of 88,115 citations and an average 440.6 citations. The United States of America (USA) contributed the most with 110 articles; the top institution was the University of Toronto with 34 publications. Most studies focused on basic science research on SCI. Keyword analysis revealed the most commonly used keywords: SCI, inflammation, apoptosis, incidence/prevalence, and regeneration; four word-clusters were identified. Institutions from the USA and Canada collaborated the most and two major and two minor institutional collaboration subnetworks were identified. Co-citation analysis detected three main clusters of authors. Conclusion This overview of the most cited articles on traumatic spinal cord and spinal column injuries provides insight into the international spinal trauma community and the terrain in this field, potentially acting as a springboard for further collaboration development.
Collapse
Affiliation(s)
| | - Marios Makris
- Care of the Elderly Department, Watford General Hospital, Edinburgh, UK
| | - Andreas K. Demetriades
- Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK
- Edinburgh Spinal Surgery Outcome Studies Group, Leiden, The Netherlands
- Department of Neurosurgery, University of Leiden, Leiden, The Netherlands
| |
Collapse
|