Epidemiology of Spinal Fractures in a Level One Trauma Center in the Netherlands

Abstract

Study Design. Retrospective epidemiological study. Objective. To describe the epidemiology of spinal fractures over a 10 years period in a level one trauma center in the Netherlands. Summary of Background Data. Spinal fractures may have large socioeconomic consequences. The prevalence and outcomes likely change over the years owing to improved traffic safety, increasing population age and improved medical treatment. This is the first study to address the epidemiology of spinal fractures over a large period in the Netherlands. Methods. All patients with a cervical, thoracic, or lumbar spine fracture admitted to a level one trauma center from 2007 to 2016 were prospective registered and retrospectively analyzed. In addition to patient, accident, and associated injury characteristics, radiological and surgery data were obtained from the hospital's Electronic Patient File system. Results. Between 2007 and 2016, 1479 patients with a total of 3029 spinal fractures were admitted. Approximately 40.8% were female and 59.2% were male, with a mean age of 52.0 years; 4.9% of fractures occurred at a juvenile age (0–18 years) and 63.6% at the age of 19 to 64 years. Most fractures occurred in the thoracic spine, followed by the lumbar and cervical spine. The most common cause of injury was a fall from height, followed by traffic accidents. Spinal cord injury occurred in 8.5% and associated injuries were reported in 73% of the patients. Sixteen percent of the admitted patients were treated operatively. Over time, there was a larger increase in amount of spine fractures in elderly (≥ 65 years) compared with younger people. Conclusion. The total amount of spine fractures per year increased over time. In addition, there was a larger increase in amount of spine fractures in patients over 65 years of age compared with younger patients. Despite this increase, a considerable amount of spine fractures still occur in the age-group of 19 to 64 years. Most fractures were located in the thoracic spine. This study might stimulate development of policy on precautionary actions to prevent spine fractures. Level of Evidence: 4

Epidemiology of Spinal cord Injury in references trauma center in Curitiba (Paraná, Brazil)

“…The greatest involvement of the lumbar level, with emphasis on the thoracolumbar transition, is also compatible with other studies in the literature, 5,11,14 but differs from the Dutch article 12 in which there was greater involvement of the thoracic level with a significant 42.8% of cases.…”

“…However, this mechanism is presented as the second most common, followed by same level falls. In addition, these three mechanisms account for approximately 80% of the cases in the studies cited, [10][11][12] being similar to the present study, in which they account for 88.23% of the cases.…”

“…We observed a difference of 10 years between the mean ages of the males and female patients. This involvement in an older female population was also observed in the Dutch study by Den Ouden 12 in which the mean age of the men was 48.9 years and of the women was 56.4 years. These data point to a probable correlation with the higher incidence of osteopenia/osteoporosis in women.…”

“…Regarding the mechanisms analyzed, traffic accidents had the highest incidence, accounting for approximately one third of the cases. (Table 1) These data differ from those of large studies in the literature [10][11][12] conducted in other countries (Germany, 10 China, 11 the Netherlands 12 ) that found higher level falls to be the main mechanism of trauma.…”

“…The studies of Brito 3 and De Campos, 5 were two Brazilian studies with less than 100 patients, which obtained an approximate mean age of 35 years, a mean less than that found in the present study (48.23 years). The German study 10 (n=562), obtained a mean age of 43.8 years, while the Dutch study 12 (n=1470) reported a mean age of 52 years. (Wang 11 (n=3142) got a mean age of 45.7 years, close to that found in this study (48.3 years).…”