The Incidence of Noncontiguous Spinal Fractures and Other Traumatic Injuries Associated With Cervical Spine Fractures: A 10-Year Experience at an Academic Medical Center

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2011-09, Vol.36 (19), p.1532-1540
• Main Authors: MILLER, Christopher P, BRUBACHER, Jacob W, BISWAS, Debdut, LAWRENCE, Brandon D, WHANG, Peter G, GRAUER, Jonathan N
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cerebrospinal fluid. Meninges. Spinal cord; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - injuries; Chi-Square Distribution; Hospitals, Teaching - statistics & numerical data; Humans; Incidence; Injuries of the nervous system and the skull. Diseases due to physical agents; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - injuries; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Occipital Bone - diagnostic imaging; Occipital Bone - injuries; Retrospective Studies; Spinal Fractures - diagnostic imaging; Spinal Fractures - epidemiology; Spinal Fractures - etiology; Spinal Injuries - complications; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - injuries; Tomography, X-Ray Computed - statistics & numerical data; Trauma Centers - statistics & numerical data; Traumas. Diseases due to physical agents; Wounds and Injuries - complications
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/BRS.0b013e3181f550a6

Retrospective medical record review. The purpose of this study was to describe the incidence of other injuries that commonly occur in conjunction with cervical spine fractures and dislocations. Cervical spine fractures are often associated with other significant traumatic conditions, which may also require prompt diagnosis and management. However, the relative incidences of the injuries that occur in conjunction with various cervical spine fractures have not been well documented. The radiographic reports of all patients who underwent CT scans of the cervical spine at a single level 1 trauma center over a 10-year period were reviewed. The medical records of individuals with acute, nonpenetrating fractures of the cervical spine were further assessed for any associated traumatic pathology including noncontiguous spine injuries and those affecting other organ systems (i.e., head and neck, intrathoracic, intra-abdominal/pelvic, and nonspinal orthopedic disorders). A total of 13,896 CT scans of the cervical spine were performed during this 10-year period of which 492 revealed acute fractures and/or dislocations. Of these subjects, 60% had sustained at least one additional injury. Overall, 57% were noted to have extraspinal injuries (34% head and neck, 17% intrathoracic, 10% intra-abdominal/pelvic, and 30% nonspinal orthopedic conditions) and noncontiguous spinal trauma was present in 19% of these cases (8% cervical injuries, 8% thoracic, and 6% lumbar). In general, the rates of associated injuries observed with occipital condyle and C7 fractures were significantly higher than those recorded for other cervical segments. For patients with a known history of cervical spine trauma, the frequencies of associated injuries were similar across all levels of the cervical spine with the exception of the injuries to the craniocervical junctions. In practice, this means that injuries to the cervical spine can likely be grouped together when considering other possible associated injuries. Further elucidation of these injury patterns will likely be useful for facilitating the expedient evaluation and proper management of these individuals.