National incidence of traumatic spinal fractures in China

Liu, Bo; Zhu, Yanbin; Liu, Song; Chen, Wei; Zhang, Fei; Zhang, Yingze

doi:10.1097/md.0000000000012190

Cited by 29 publications

(28 citation statements)

References 23 publications

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“…The Magerl AO spinal fracture classi cation system contains a comprehensive description of the fracture anatomy and uses successive grades in a hierarchical system to represent increased fracture severity [15]. According to epidemiological studies, the morbidity of type A1 and A3 fractures is the highest and that of type C fractures is the lowest [16], which is also consistent with the distribution of fracture types in our study. As the severity of the fracture increases, the form of intervertebral disc injury can also manifest as intervertebral disc edema, intradisc hemorrhage, the nucleus pulposus protruding into the vertebral body, or even a complete tear.…”

Section: Discussionsupporting

confidence: 87%

“…Williams et al found that Schmorl nodes were closely related to lumbar disc degeneration and low back pain, although these nodes were not independent predictors of low back pain [24]. In an epidemiological study of lumbar endplate injury, it was found that endplate irregularities were closely related to severe disc degeneration, and their risk ratio (RR) was as high as 16.09 for P rrmann grade IV or V degeneration [25].…”

Section: Discussionmentioning

confidence: 99%

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Effects of Endplate Healing Morphology on Intervertebral Disc Degeneration after Pedicle Screw Fixation for Thoracolumbar Fractures

Ren

Liu

et al. 2020

Preprint

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Background: The cartilage endplate plays an important role in the stress distribution and nutrition metabolism of intervertebral disc. The healing morphology of the endplate after spinal fracture and its effect on the intervertebral disc degeneration are still unclear. Methods: 51 patients with single-level thoracolumbar fractures underwent posterior open reduction and pedicle screw fixation. Combined with the initial CT and MRI images, the endplate injury was defined as three types, which are unilateral endplate injury, bilateral endplate injury and no endplate injury. According to the location of the injury in the endplate, it was further divided into endplate central injury and endplate peripheral injury. The degree of post-traumatic disc lesions and disc degeneration during follow-up were classified based on the Sander classification and the Pfirrmann classification, respectively. According to the T1 image of MRI in the final follow-up, the healing morphology of endplates was classified into three types including the increased endplate curvature, the irregular healing and the traumatic Schmorl nodes. Results: Cartilage endplate fractures are closely related to the degree of degeneration of the intervertebral disc (P=0.003). Injuries in different parts of the endplate have no significant effect on the intervertebral disc degeneration (P=0.204). The healing morphology after endplate fracture significantly affected the degree of intervertebral disc degeneration (P=0.001). The comparison of groups showed that the effects of irregular healing and traumatic Schmorl nodes on disc degeneration were not statistically different, but were significantly different from those with increased curvature. Conclusions: Increased endplate curvature, irregular healing and traumatic Schmorl nodes are three common forms of healing. The irregular healing and the traumatic Schmorl nodes are closely related to intervertebral disc degeneration. The existence and severity of the endplate injury can provide valuable information for individualized clinical decision-making processes.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Effects of Endplate Healing Morphology on Intervertebral Disc Degeneration after Pedicle Screw Fixation for Thoracolumbar Fractures

Ren

Liu

et al. 2020

Preprint

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“…According to a recent epidemiological survey, the incidence of spinal fractures is approximately 32.8/100 000, and thoracolumbar fractures account for 90% of spinal fractures. More than 50% of thoracolumbar fractures occur between T 11 –L 2 , which is stress concentration T 11 ‐L 2 ( ) .…”

Section: Introductionmentioning

confidence: 99%

Treatment of Thoracolumbar Fractures Through Different Short Segment Pedicle Screw Fixation Techniques: A Finite Element Analysis

Wang

Duan

et al. 2020

Orthopaedic Surgery

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Objective: To compare the von Mises stresses of the pedicle screw system and the displacement of injured vertebrae using 3-D finite element analysis, and to evaluate the curative effect of the pedicle screw system. Methods:Finite element methods were used for biomechanical comparison of four posterior short segment pedicle screw fixation techniques. The different pedicle screw models are traditional trajectory (TT), Universal Spine System (USS), cortical bone trajectory (CBT), and CBT at the cranial level and pedicle screw (PS) at the caudal level (UP-CBT). The stress distribution of the screws and connecting rods under different working conditions and the displacement of the injured vertebrae were compared and analyzed.Results: After the pedicle screw system was fixed, the stress under vertical compression was mainly concentrated at the proximal end of the screw, while the stress was mainly concentrated on the connecting rod during flexion, extension, lateral flexion, and rotation. The TT group had the greatest stress during the flexion, extension, and left and right rotation. The UP-CBT group was most stressed when the left and right sides were flexed; the stress of the USS screw system was less than that of the other three models during flexion, lateral flexion, and rotation. The maximum von Mises stress values of pedicle screws in all exercise states were 556.2, 340.7, 458.1, and 533.4 MPa, respectively. In the USS group, the displacement of the injured vertebra was small in the flexion, and the left and right lateral flexion and the right rotation were higher than in the TT group and the CBT group. The maximum displacements of the injured vertebrae in all motion states were 1.679, 1.604, 1.752, and 1.777 mm, respectively.Conclusion: Universal Spine System pedicle screws are relatively less stressed under different working conditions, the risk of breakage is small, and the model is relatively stable; CBT screws do not exhibit better mechanical properties than conventional pedicle screws and USS pedicle screws.

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“…Liu et al. 19 showed that the risk of traumatic spinal fracture was 80% higher in those who did than did not consume alcohol. Similarly, Liu et al.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological investigation of hospitalized patients with traumatic fractures: a cross-sectional study

Jin

et al. 2021

J Int Med Res

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Objective This study was performed to explore major risk factors for traumatic fracture by comparing related data of hospitalized patients with traumatic fracture and patients with lumbar disc herniation. Methods Patients with traumatic fracture and patients with lumbar disc herniation requiring surgical treatment in the orthopedics department of our hospital from March to May 2018 were divided into a fracture group and a non-fracture group. Clinical data were collected from the two groups by questionnaires. Major risk factors for traumatic fracture were analyzed using multivariate logistic regression. Results Univariate analysis showed statistically significant differences in family history of fracture, smoking history, drinking history, sex, sleep duration, chronic disease history, osteoporosis history, age, body mass index, occupation, and education level between the two groups. Multivariate logistic regression analysis showed that patients aged 25 to 44 years were more prone to traumatic fracture than patients aged ≥65 years, male patients were more prone to fracture than female patients, drinking alcohol was a risk factor for traumatic fracture, and sufficient sleep duration (>7 hours/night) was a protective factor for traumatic fracture. Conclusion Young age, male sex, and drinking are risk factors for traumatic fracture, whereas sufficient sleep duration is a protective factor.

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National incidence of traumatic spinal fractures in China

Cited by 29 publications

References 23 publications

Effects of Endplate Healing Morphology on Intervertebral Disc Degeneration after Pedicle Screw Fixation for Thoracolumbar Fractures

Effects of Endplate Healing Morphology on Intervertebral Disc Degeneration after Pedicle Screw Fixation for Thoracolumbar Fractures

Treatment of Thoracolumbar Fractures Through Different Short Segment Pedicle Screw Fixation Techniques: A Finite Element Analysis

Epidemiological investigation of hospitalized patients with traumatic fractures: a cross-sectional study

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