J Korean Fract Soc.  2012 Jul;25(3):203-207.

Injury Severity and Patterns of Accompanying Injury in Spinal Fracture

• Park H
• Song KJ
• Lee KB
• Sim JH

Abstract

PURPOSE
To examine the relationship between injury severity and patterns of associated injury in spinal fracture.
MATERIALS AND METHODS
From March 2004 to March 2010, a retrospective study was conducted on 291 patients who had undergone surgeries due to spinal fractures. Spinal fractures were categorized as upper cervical, lower cervical, thoracic, thoracolumbar, and lumbar region, and the severity of fracture was measured using the Abbreviated Injury Scale and Injury Severity Score (ISS). We evaluated the correlation between the fracture site and the incidence and injury severity of the associated injury, and compared the neurologic damage according to the presence/absence of the associated injury.
RESULTS
Spinal fracture occurred in the thoracic (43.5%) and lower cervical (30.0%) levels, and associated injury developed in 134 patients (47%). The area of associated injury was in the extremity (41.2%), thorax (25.5%), head, neck, and face (21.9%). Lower cervical fracture (34.5%) had a lower prevalence than thoracic (81%) and lumbar fracture (61%). The average ISS of the associated injury was 17.14 for the thoracic fracture, 12.30 for the lower cervical fracture, 8.7 for the thoracolumbar fracture and 5.69 for the lumbar fracture. Neurologic damage was highly frequent in the lower cervical fracture and included 54 patients (62.1%) and was less frequent in the upper cervical fracture, which included 7 patients (17.9%) (p=0.032).
CONCLUSION
Although the associated injury was less frequent in the lower cervical spine among the spinal fractures that underwent surgical treatment, there was a high risk of neurologic damage in the case of associated injury; therefore, there is a need to pay special attention to patients that suffer damage in this area. In addition, since the degree of the associated injury in the thoracic and lower cervical fracture is significant, an appropriate management strategy for the associated injury must be considered.

Keyword

Multiple trauma; Spinal fracture; Associated injury

MeSH Terms

Abbreviated Injury Scale
Extremities
Head
Humans
Incidence
Injury Severity Score
Lumbosacral Region
Multiple Trauma
Neck
Prevalence
Retrospective Studies
Spinal Fractures
Spine
Thorax

Figure

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  Fig. 1 The histogram demonstrates the relationship between the location of the associated injury and the injury mechanism. Direct trauma and others, Fall (s): fall from standing, Fall (he): fall from height, MVA (m): motor vehicle accident, motorcyclist, MVA (p): motor vehicle accident, pedestrian, MVA (o): motor vehicle accident, occupant.

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  Fig. 2 The histogram demonstrates the incidence of associated injury according to the location of the vertebral fracture.

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  Fig. 3 The histogram demonstrates the distribution and frequency ofassociated injuries according to the location of the vertebral fracture.

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  Fig. 4 The histogram demonstrates the Injury Severity Score of the associated injuries according to the location of the vertebral fracture.

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  Fig. 5 The histogram demonstrates the incidence of neurologic deficit according to the location of the vertebral fracture.

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