Spinal Injuries in Pedestrians Struck by Motor Vehicles

Abstract

Spinal injuries in pedestrians struck by motor vehicles are more evenly distributed throughout the spinal column and more often coexist with injuries to remote organs compared with car occupants and motorcyclists where regional tendencies and isolated spinal injuries are more frequent. A systematic approach to both diagnosis and treatment is, therefore, necessary. Helical truncal CT, performed to evaluate visceral injury, effectively screens for TL fractures.

Valor diagnóstico da tomografia de coluna cervical em vítimas de trauma contuso

“…The most commonly reported mechanism of injury in cervical spine injuries is represented by accidents involving motor vehicles, with 44% of cases, followed by violence / assault (24%), falls (22%), sports activities (8%), and other causes (2%) 5,16 . In the present study, we observed a high incidence of traffic accidents, with 74.4% involving motor vehicles (23.5% of pedestrian accidents, 35.3% of car collisions and 15.6% of motorcycle accidents), followed by falls from a height, with 15.6% (Table 3).…”

“…Several diagnostic methods are used to identify such lesions, from physical examination to more sophisticated imaging tests, such as computed tomography (CT) and magnetic resonance imaging (MRI) 5,8,12 , CT being the most used feature, allowing to Pinheiro Pinheiro Pinheiro Pinheiro Pinheiro Diagnostic value of tomography of the cervical spine in victims of blunt trauma characterize the presence or absence of injury to the cervical spinal column in most cases 11,12 . Like all diagnostic methods, CT has limitations, has its costs and its indication criteria are not strictly accurate, possibly leading the physician to indicate it unnecessarily or fail to indicate it, hampering the accurate diagnosis of an important lesion 9 .…”

“…For every death due to trauma there are 19 hospital admissions, 233 medical consultations and 450 emergencies consultations 1,3,4 . Also in the U.S., 7,800 people annually (32 per million population) suffer spinal cord injuries due to trauma to the spine, the cervical spine representing nearly half (48.7%) of these victims 5 . In Europe,trauma is also the leading cause of death in people up to 40 years of age 3,6 .…”

“…In addition, it causes large health system expenditures, both with prolonged hospitalization and treatment, which usually lasts for years 5,8 . Besides medical treatment, social and economic costs resulting from cervical spinal cord injuries are enormous, as up to 85% of victims who resist the first 24 hours after trauma survive for more than 10 years 3 and, being in the productive age group, suffer large reduction in productivity due to prolonged absences from work, early retirement and unemployment 2,5,[8][9][10] .Hence the great importance of early and accurate diagnosis of lesions of the spine and cervical spinal cord in victims of blunt trauma 11,12 . Several diagnostic methods are used to identify such lesions, from physical examination to more sophisticated imaging tests, such as computed tomography (CT) and magnetic resonance imaging (MRI) 5,8,12 , CT being the most used feature, allowing to Pinheiro Pinheiro Pinheiro Pinheiro Pinheiro Diagnostic value of tomography of the cervical spine in victims of blunt trauma characterize the presence or absence of injury to the cervical spinal column in most cases 11,12 .…”

“…Besides medical treatment, social and economic costs resulting from cervical spinal cord injuries are enormous, as up to 85% of victims who resist the first 24 hours after trauma survive for more than 10 years 3 and, being in the productive age group, suffer large reduction in productivity due to prolonged absences from work, early retirement and unemployment 2,5,[8][9][10] .…”