Cervical spine injuries in patients with head injuries

Soicher, E.; Δημητριάδης, Δημήτριος

doi:10.1002/bjs.1800780837

Cited by 33 publications

(23 citation statements)

References 5 publications

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“…Lower rates have been cited in reports that detail less precisely the severity of the TBI and the methods of evaluation. 3,40,54 In infancy, excepting cases of abusive head injury, the rates of spinal injury associated with TBI have seemed to be quite low. 2,8,19,30 The current study reports spinal injury rates of 9.8% for NTDB admissions coded for TBI and 10.9% for admissions coded for GCS motor ≤ 4, but all spinal levels have been counted.…”

Section: Discussionmentioning

confidence: 99%

Pediatric spinal injury in the US: epidemiology and disparities

Piatt¹

2015

PED

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OBJECT In the US, race and economic status have pervasive associations with mechanisms of injury, severity of injury, management, and outcomes of trauma. The goal of the current study was to examine these relationships on a large scale in the setting of pediatric spinal injury. METHODS Admissions for spinal fracture without or with spinal cord injury (SCI), spinal dislocation, and SCI without radiographic abnormality were identified in the Kids’ Inpatient Database (KID) and the National Trauma Data Bank (NTDB) registry for 2009. Patients ranged in age from birth up to 21 years. Data from the KID were used to estimate nationwide annual incidences. Data from the NTDB were used to describe patterns of injury in relation to age, race, and payor, with corroboration from the KID. Multiple logistic regression was used to model rates of mortality and spinal fusion. RESULTS In 2009, the estimated incidence of hospital admission for spinal injury in the US was 170 per 1 million in the population under 21 years of age. The incidence of SCI was 24 per 1 million. Incidences varied regionally. Adolescents predominated. Patterns of injury varied by age, race, and payor. Black patients were more severely injured than patients of other races as measured by Injury Severity Scale scores. Among black patients with spinal injury in the NTDB, 23.9% suffered firearm injuries; only 1% of white patients suffered firearm injuries. The overall mortality rate in the NTDB was 3.9%. In a multivariate analysis that included a large panel of clinical and nonclinical factors, black race retained significance as a predictor of mortality (p = 0.006; adjusted OR 1.571 [1.141–2.163]). Rates of spinal fusion were associated with race and payor in the NTDB data and with payor in the KID: patients with better insurance underwent spinal fusion at higher rates. CONCLUSIONS The epidemiology of pediatric spinal injury in the US cannot be understood apart from considerations of race and economic status.

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Section: Discussionmentioning

confidence: 99%

Pediatric spinal injury in the US: epidemiology and disparities

Piatt¹

2015

PED

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“…However, most studies did not specifically exclude paediatric patients [1,7,9,12,16,23,24,27,28,33,34,37,41,47] and included a limited number of paediatric patients in their analysis. These studies were only included if they took place in adult hospitals/trauma centres or reported the number of paediatric patients included to be minimal.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Nine included studies were conducted in the USA [2,7,9,15,16,21,28,33,34]; 3 in the UK [1,12,19]; 2 in China [41,47]; and 1 in each of Pakistan [30], Taiwan [6], Australia [27], South Africa [37], Japan [23], Germany [24], and Canada [35]. Studies were not excluded based on publication year.…”

Section: Study Characteristicsmentioning

confidence: 99%

Prevalence of concomitant traumatic cranio-spinal injury: a systematic review and meta-analysis

Pandrich

Demetriades

2018

Neurosurg Rev

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The biomechanical relationship between cranial and spinal structures makes concomitant injury likely. Concomitant craniospinal injuries are important to consider following trauma due to the serious consequences of a missed injury. The objective of this review was to estimate the prevalence of concomitant cranio-spinal injury in the adult trauma population. A systematic search of MEDLINE and EMBASE databases to identify observational studies reporting the prevalence of concomitant cranio-spinal injury in the general adult trauma population was conducted on 21 March 2017. The prevalence of concomitant cervical spinal injury in patients with a traumatic brain injury (TBI); the prevalence of concomitant spinal injury in patients with a TBI; the prevalence of concomitant TBI in patients with a cervical spinal injury; and the prevalence of concomitant TBI in patients with a spinal injury were calculated by meta-analysis. Twenty-one studies met the inclusion criteria and were included in this review. The prevalence of concomitant cervical spinal injury in patients with a TBI was found to be 6.5% (95% CI 6.0-7.1%); the prevalence of concomitant spinal injury in patients with a TBI to be 12.4-12.5%; the prevalence of concomitant TBI in patients with a cervical spinal injury to be 40.4% (95% CI 33.0-48.0%); and the prevalence of concomitant TBI in patients with a spinal injury to be 32.5% (95% CI 10.8-59.3%). This review reports the prevalence of concomitant cranio-spinal injury and highlights the importance of considering concomitant injury in patients with a cranial or spinal traumatic injury.

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“…1,2 Recent studies have suggested a potential detrimental effect of cervical collars on patients with severe head injury by demonstrating that cervical collars can elevate intracranial pressure (ICP). [3][4][5][6][7][8] Increased ICP decreases cerebral perfusion and exacerbates ischemia, thus increasing the likelihood of secondary brain injury.…”

mentioning

confidence: 99%

The Effect of Rigid Cervical Collars on Internal Jugular Vein Dimensions

Stone

Tubridy

Curran

2010

Academic Emergency Medicine

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Objectives: Prior research has demonstrated that rigid cervical collars cause an increase in intracranial pressure (ICP). The mechanism for this effect is unclear and one proposed mechanism involves obstruction of venous outflow in the neck. Ultrasound (US) allows assessment of internal jugular vein dimensions and may yield information regarding the mechanism for the increase in ICP seen with rigid collar application.Methods: Forty-two healthy volunteers underwent US examination of the internal jugular vein before and after cervical collar application. Internal jugular vein cross-sectional areas were compared with and without the cervical collar in place. Results:The cross-sectional area of the internal jugular vein increased significantly (p < 0.0001) after application of the cervical collar. The mean percentage increase in cross-sectional area was 37% (95% confidence interval [CI] = 20% to 53%).Conclusions: Internal jugular vein cross-sectional area increases after application of a rigid cervical collar. This supports the hypothesis that venous obstruction in the neck may contribute to the increase in ICP seen after rigid collar application.

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Cervical spine injuries in patients with head injuries

Cited by 33 publications

References 5 publications

Pediatric spinal injury in the US: epidemiology and disparities

Pediatric spinal injury in the US: epidemiology and disparities

Prevalence of concomitant traumatic cranio-spinal injury: a systematic review and meta-analysis

The Effect of Rigid Cervical Collars on Internal Jugular Vein Dimensions

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