Cervical spinal cord injury after blunt assault: Just a pain in the neck?

• Published in: The American journal of surgery 2019-04, Vol.217 (4), p.648-652
• Main Authors: Eskesen, Trine G., Baekgaard, Josefine S., Peponis, Thomas, Moo Lee, Jae, Saillant, Noelle, Kaafarani, Haytham M.A., Fagenholz, Peter J., King, David R., de Moya, Marc, Velmahos, George C., Yeh, D. Dante
• Format: Article
• Language: English
• Subjects: Adult; Age; Alcohol; Blunt assault; Cervical spinal cord injury; Cervical spine injury; Cervical Vertebrae - injuries; Concussion; Data banks; Databases, Factual; Demographics; Dislocation; Dislocations; Female; Fracture Dislocation - complications; Fracture Dislocation - epidemiology; Fractures; Human papillomavirus; Humans; Incidence; Injuries; Male; Middle Aged; Neck; Neck Injuries - complications; Neck Injuries - epidemiology; NMR; Nuclear magnetic resonance; Pain; Risk analysis; Risk Factors; Spinal cord injuries; Spinal Cord Injuries - epidemiology; Spinal Cord Injuries - etiology; Spinal Fractures - complications; Spinal Fractures - epidemiology; Trauma; United States - epidemiology; Ventilators; Vertebrae; Violence; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - epidemiology
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2018.06.022

We aimed to determine the incidence, risk factors, and outcomes of cervical spinal cord injury (CSCI) after blunt assault. The ACS National Trauma Data Bank (NTDB) 2012 Research Data Set was used to identify victims of blunt assault using the ICD-9 E-codes 960.0, 968.2, 973. ICD-9 codes 805.00, 839.00, 806.00, 952.00 identified cervical vertebral fractures/dislocations and CSCI. Multivariable analyses were performed to identify independent predictors of CSCI. 14,835 (2%) out of 833,311 NTDB cases were blunt assault victims and thus included. 217 (1%) had cervical vertebral fracture/dislocation without CSCI; 57 (0.4%) had CSCI. Age ≥55 years was independently predictive of CSCI; assault by striking/thrown object, facial fracture, and intracranial injury predicted the absence of CSCI. 25 (0.02%) patients with CSCI underwent cervical spinal fusion. CSCI is rare after blunt assault. While the odds of CSCI increase with age, facial fracture or intracranial injury predicts the absence of CSCI. The incidence, risk factors, and outcomes of cervical spinal cord injury (CSCI) after blunt assault was investigated. 14,835 blunt assault victims were identified; 217 had cervical vertebral fracture/dislocation without CSCI; 57 had CSCI. Age ≥55 years was found to independently predict CSCI, while assault by striking/thrown object, facial fracture, and intracranial injury predicted the absence of CSCI. •Cervical vertebral fracture/dislocation after blunt assault is not common.•Cervical spinal cord injury after blunt assault is even more rare.•The odds of cervical spinal cord injury after blunt assault increases with age.