The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway

Abstract

AimThe aim of this study was to estimate the incidence of traumatic cervical spine fractures (CS-fx) in a general population.BackgroundThe incidence of CS-fx in the general population is largely unknown.MethodsAll CS-fx (C0/C1 to C7/Th1) patients diagnosed with cervical-CT in Southeast Norway (2.7 million inhabitants) during the time period from April 27, 2010-April 26, 2011 were prospectively registered in this observational cohort study.ResultsOver a one-year period, 319 patients with CS-fx at one or more levels were registered, constituting an estimated incidence of 11.8/100,000/year. The median age of the patients was 56 years (range 4–101 years), and 68% were males. The relative incidence of CS-fx increased significantly with age. The trauma mechanisms were falls in 60%, motorized vehicle accidents in 21%, bicycling in 8%, diving in 4% and others in 7% of patients. Neurological status was normal in 79%, 5% had a radiculopathy, 8% had an incomplete spinal cord injury (SCI), 2% had a complete SCI, and neurological function could not be determined in 6%. The mortality rates after 1 and 3 months were 7 and 9%, respectively. Among 319 patients, 26.6% were treated with open surgery, 68.7% were treated with external immobilization with a stiff collar and 4.7% were considered stable and not in need of any specific treatment. The estimated incidence of surgically treated CS-fx in our population was 3.1/100,000/year.ConclusionsThis study estimates the incidence of traumatic CS-fx in a general Norwegian population to be 11.8/100,000/year. A male predominance was observed and the incidence increased with increasing age. Falls were the most common trauma mechanism, and SCI was observed in 10%. The 1- and 3-month mortality rates were 7 and 9%, respectively. The incidence of open surgery for the fixation of CS-fx in this population was 3.1/100,000/year.Level of evidenceThis is a prospective observational cohort study and level II-2 according to US Preventive Services Task Force.

Demographic and clinical characteristics of patients with traumatic cervical spinal cord injury: a Turkish hospital-based study

“…Incomplete CSCIs have been reported to occur more often than complete CSCI. 6,10,17 Our finding was in line with these studies. It has also been reported that the percentage of incomplete CSCI is increasing, compared with complete CSCI.…”

“…Our findings show that fewer children and old individuals had CSCI compared with other age groups. Pickett et al 11 and Fredø et al 17 reported that the incidence of patients aged 460 years with CSCI was 26.5% and 54.5%, respectively, which are much higher than that observed in the present study (6.2%).…”

“…Patients with fall-related injuries tended to be older. 10,17 Simple fall-related CSCI accounted for 5% of all cases, a relatively low percentage that was consistent with the number of patients aged 60 years. The third most common cause of CSCI was diving into shallow water, which is not surprising in consideration of Turkey's extensive shoreline.…”

Epidemiology of atlas fractures—a national registry–based cohort study of 1,537 cases

“…Our findings documented that this trend has continued in the case of atlas fractures. Several studies find that simple falls are the most common causes of cervical fractures in the elderly [15][16][17][18][19]. One possible explanation for the increased incidence could be an increase in the number of falls in the elderly population.…”

Diagnosis and Treatment of Cervical Radiculopathy and Myelopathy

“…[8][9][10] Examples of these injuries include motor vehicle crashes, high impact accidents, explosions, and gunshots. [11][12][13] An acute injury to the cervical spine should be clinically diagnosable as work-related within 3 months of the injury.…”