Stephen P Burns1,2, Frances Weaver3,4, Amy Chin5, Jelena Svircev1, Laura Carbone6,7. 1. a Spinal Cord Injury Service , Department of Veterans Affairs- Puget Sound Health Care System , Seattle , WA , USA. 2. b Department of Rehabilitation Medicine , University of Washington , Seattle , WA , USA. 3. c Director, Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital , Chicago , IL , USA. 4. d Stritch School of Medicine , Loyola University , Chicago , IL , USA. 5. e Edward J. Hines, Jr. Veterans Affairs Hospital , Hines , IL , USA. 6. f Charlie Norwood Veterans Affairs Medical Center , Augusta , GA , USA. 7. g Medical College of Georgia, Department of Medicine , Augusta University , Augusta , GA , USA.
Abstract
CONTEXT/ OBJECTIVE: The purpose of this study was to characterize etiologies of spinal cord injury and disorders (SCI/D) in persons with and without cervical stenosis/spondylosis (CSS) and to describe clinical characteristics and underlying comorbidities in these populations. DESIGN AND SETTING: We reviewed administrative data for 1954 Veterans who had onset of traumatic or non-traumatic tetraplegia during FY 1999-2007. This included 1037 with a diagnosis of CSS at or in the two years prior to SCI onset of SCI/D and 917 without a diagnosis of CSS. OUTCOME MEASURES: Demographics, etiologies of SCI/D and comorbidities by CSS status. RESULTS: Veterans with SCI/D and CSS were older, more likely to have incomplete injuries and more likely to be Black than those with SCI/D and no CSS. Of patients with traumatic etiologies for SCI, 35.1% had a diagnosis of CSS at the time of or in the 2 years prior to SCI onset. Of those with tetraplegia due to falls, 40.0% had CSS, whereas for other known traumatic etiologies the percentages with CSS were lower: vehicular (25.0%); sports (16.1%); and acts of violence (10.2%). Total comorbidity scores measured by the Charlson co morbidity index and CMS Hierarchical Condition Category (CMS-HCC) were higher in those with CSS and SCI/D compared to those with SCI/D without CSS (P < 0.0001 respectively). CONCLUSIONS: CSS is commonly present in patients with new traumatic tetraplegia. Falls are a particularly important potentially modifiable risk for SCI in patients with CSS.
CONTEXT/ OBJECTIVE: The purpose of this study was to characterize etiologies of spinal cord injury and disorders (SCI/D) in persons with and without cervical stenosis/spondylosis (CSS) and to describe clinical characteristics and underlying comorbidities in these populations. DESIGN AND SETTING: We reviewed administrative data for 1954 Veterans who had onset of traumatic or non-traumatic tetraplegia during FY 1999-2007. This included 1037 with a diagnosis of CSS at or in the two years prior to SCI onset of SCI/D and 917 without a diagnosis of CSS. OUTCOME MEASURES: Demographics, etiologies of SCI/D and comorbidities by CSS status. RESULTS: Veterans with SCI/D and CSS were older, more likely to have incomplete injuries and more likely to be Black than those with SCI/D and no CSS. Of patients with traumatic etiologies for SCI, 35.1% had a diagnosis of CSS at the time of or in the 2 years prior to SCI onset. Of those with tetraplegia due to falls, 40.0% had CSS, whereas for other known traumatic etiologies the percentages with CSS were lower: vehicular (25.0%); sports (16.1%); and acts of violence (10.2%). Total comorbidity scores measured by the Charlson co morbidity index and CMS Hierarchical Condition Category (CMS-HCC) were higher in those with CSS and SCI/D compared to those with SCI/D without CSS (P < 0.0001 respectively). CONCLUSIONS:CSS is commonly present in patients with new traumatic tetraplegia. Falls are a particularly important potentially modifiable risk for SCI in patients with CSS.
Authors: Martin Halle; Anders Gabrielsen; Gabrielle Paulsson-Berne; Caroline Gahm; Hanna E Agardh; Filip Farnebo; Per Tornvall Journal: J Am Coll Cardiol Date: 2010-03-23 Impact factor: 24.094
Authors: Molly T Vogt; Peggy Mannen Cawthon; James D Kang; William F Donaldson; Jane A Cauley; Michael C Nevitt Journal: Spine (Phila Pa 1976) Date: 2006-06-01 Impact factor: 3.468
Authors: Marcel F Dvorak; Charles G Fisher; Joel Hoekema; Michael Boyd; Vanessa Noonan; Peter C Wing; Brian K Kwon; Brian Kwon Journal: Spine (Phila Pa 1976) Date: 2005-10-15 Impact factor: 3.468