Alterations of the biomarker S-100B and NSE in patients with acute vertebral spine fractures

• Published in: The spine journal 2014-12, Vol.14 (12), p.2918-2922
• Main Authors: Wolf, Harald, MD, Krall, Christoph, PhD, Pajenda, Gholam, MD, Leitgeb, Johannes, MD, Bukaty, Adam J., MD, Hajdu, Stefan, MD, Sarahrudi, Kambiz, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biomarker; Biomarkers - blood; Case-Control Studies; Female; Femoral Fractures - blood; Humans; Male; Middle Aged; Neurologic deficit; NSE; Orthopedics; Phosphopyruvate Hydratase - blood; S100 Proteins - blood; S100B; Spinal cord injury; Spinal Fractures - blood; Spinal trauma; Vertebral spine fractures
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2014.04.027

Abstract Background context Although several publications concerning the use of the biomarkers S100B and neuron-specific enolase (NSE) in vertebral spine fractures in animal experimental studies have proven their usefulness as early indicators of injury severity, there are no clinical reports on their effectiveness as indicators in patients with spinal injuries. As these biomarkers have been examined, with promising results, in patients with traumatic brain injury, there is a potential for their implementation in patients with vertebral spine fractures. Purpose To investigate the early serum measurement of S100B and NSE in patients with vertebral spine fractures compared with those in patients with acute fractures of the proximal femur. Study design Prospective longitudinal cohort study. Patient sample A cohort of 34 patients admitted over an 18-month period to a single medical center for suspected vertebral spine trauma. Twenty-nine patients were included in the control group. Outcome measures S100B and NSE serum levels were assessed in different types of vertebral spine fractures. Methods We included patients older than 16 years with vertebral spine fractures whose injuries were sustained within 24 hours before admission to the emergency room and who had undergone a brief neurologic examination. Spinal cord injuries (SCIs) were classified as being paresthesias, incomplete paraplegias, or complete paraplegias. Blood serum was obtained from all patients within 24 hours after the time of injury. Serum levels of S100B and NSE were statistically analyzed using Wilcoxon signed-rank test. Results S100B serum levels were significantly higher in patients with vertebral spine fractures (p=.01). In these patients, the mean S100B serum level was 0.75 μg/L (standard deviation [SD] 1.44, 95% confidence interval [CI] 0.24, 1.25). The mean S100B serum level in control group patients was 0.14 μg/L (SD 0.11, 95% CI 0.10, 0.19). The 10 patients with neurologic deficits had significantly higher S100B serum levels compared with the patients with vertebral fractures but without neurologic deficits (p=.02). The mean S100B serum level in these patients was 1.18 μg/L (SD 1.96). In the 26 patients with vertebral spine fractures but without neurologic injury, the mean S100B serum level was 0.42 μg/L (SD 0.91, 95% CI 0.08, 0.76). The analysis revealed no significant difference in NSE levels. Conclusions We observed a significant correlation not only between S100B serum levels and v