Distribution of Spinal and Associated Injuries in Multiple Trauma Patients

Abstract

Injury to the spinal column and cord are often part of life-threatening multiple trauma. Epidemiological data could help to establish an evidence-based assessment and therapy of these patients. We present a retrospective chart analysis of 590 multiple traumatized patients admitted within a 4-year-period. Patients suffering from injuries of the spinal column were analysed regarding mechanism and distribution of their injuries to all body regions. Thirty-one percent (n = 183) of polytraumatized patients displayed a spine injury. Distribution analysis showed peaks in the cervical spine and the thoraco-lumbar junction. The risk of relevant associated injuries is mainly influenced from anatomical vicinity to the injured spinal segment. Injuries to the spinal column are frequent in the multiple trauma patients population. Diagnosed injuries to distinct body regions should make the trauma team suspicious of injury to the nearby spinal column. Appropriate treatment includes thorough assessment of all injuries to clarify the damage and carry on special protection of these spinal regions preventing from deterioration.

Epidemiology of Spine Trauma in Patients With Polytrauma

“…In total, the proportion that we observed for the total number of type A fractures was considerably higher than that reported by Leucht et al 2 As for neurological lesions, the incidence is similar to that reported by Leucht et al, 2 Chu et al, 3 and Laurer et al 1 (24.7%, 27.6%, and 24.6% respectively), and the distribution by Frankel classification, in total, is similar to that reported previously. The distribution by segment according to the Frankel classification is relatively uniform for Frankel E.…”

“…In terms of injury mechanisms, Leucht et al 2 divide falls into high--energy and low-energy, the former causing 39% of the injuries and the latter causing 20%, as different from Anwar, 4 who reports motor vehicle accidents in first place at 37.4%, falls at 24% (falls from heights), and falling down the stairs at 12.6%. On the other hand, Laurer et al 1 report automobile accidents at 31%, motorcycles at 12%, and falls at a total of 40%. We observed results similar to those of Leucht et al, 2 with the combined percentage of falls at 63.16%, followed by motor vehicle accidents at 21.05%.…”

“…[1][2][3][4][5] Little is said about patients who suffer from multiple trauma in basic orthopedic and spine surgery books. [6][7][8] Patients with spinal trauma are a group who require special attention for their treatment and rehabilitation because of the costs that they generate in the medical, economic, and social environments.…”

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

“…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.…”

Frequency of Vertebral Fractures in High-Energy Trauma

“…6 In the global scenario, Laurer et al stated that there is a correlation between age, sex, and the cause of the accident and the type and distribution of the fractures, as well as the number of spine fractures that occur with associated injuries, extremely useful information for improving diagnostic and patient care protocols. 7 Despite the vast knowledge of biomechanics and spinal stability, little is known at the global and national levels about the epidemiology of these injuries, which is why it is important to highlight the growing problem that it represents in our country, as reported in a study conducted at the Hospital de Traumatología y Ortopedia de Lomas Verdes in the state of Mexico, in which most of these injuries were secondary to falls from heights, followed by traffic accidents. The lumbar spine was the most affected segment in this series, with 76% of the patients with neurological involvement upon arrival at emergency services, 8 highlighting the key points in which a culture of prevention could have an impact in reducing these injuries and their sequelae.…”