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. 2022 Mar 3:10:100109.
doi: 10.1016/j.xnsj.2022.100109. eCollection 2022 Jun.

Patterns of concomitant injury in thoracic spine fractures

Patrick Curtin  1 , Benjamin Mitchell  1 , Jay Patel  1 , Jenna Lansbury  1 , Patrick Connolly  1 , Michael Stauff  1
Affiliations

Patterns of concomitant injury in thoracic spine fractures

Patrick Curtin et al. N Am Spine Soc J. .

Abstract

Background: Thoracic spine fractures (TSFs) are rarely isolated injuries, and they tend to present with a characteristic set of vertebral and non-vertebral injuries based on mechanism of injury. There is limited research on the rates and distribution of injuries that occur concurrently with TSFs. The purpose of this study is to characterize the distributions of these injuries by region of the body and by mechanisms of injury, so that trauma and spine surgeons can efficiently evaluate and treat patients presenting with TSFs.

Methods: We retrospectively reviewed the trauma database records of 683 patients presenting with a TSFs at a single institution from 2015 to 2019. We recorded patient demographics, comorbidities, and associated injuries by body region. We characterized the TSFs using the AO classification system, as well as the presenting physical exam and treatment. All associated injuries among the TSF patients were classified into the following categories: head injury (HI), thoracic injury (TI), non-thoracic vertebral injury (NTVI), abdominal injury (AI), upper extremity injury (UEI), lower extremity injury (LEI), and spinal cord injury (SCI).

Results: The three leading causes of TSFs were mechanical falls (38.4%), falls from height (24.9%), and motor vehicle crashes (MVCs) (23.4%). Patients with a TSF from MVC were statistically more likely to have concomitant injuries of TI, NTVI, AI, HI, UEI, and LEI. TSFs from fall from height were statistically more likely to have TI, NTVI, and LEI. TSFs from mechanical falls had significantly lower rates of all injury locations, but still presented with high rates of additional injury. TSFs from motorcycle crashes (MCCs) presented with TI, AI, UEI, and LEI. There were high rates of treatment for TSFs, with surgery ranging from 5.3% to 20.0% and bracing from 52.3% to 65.7% depending on mechanism of injury.

Conclusions: TSFs after MVCs, mechanical falls, falls from height, and MCCs presented with a predictable pattern of injuries and were rarely an isolated injury. This cross-sectional data may help spine and trauma surgeons better understand patterns of injury associated with TSFs, with the hope of preventing missed injuries and better advising patients with TSFs on severity of injuries.

Keywords: Brace; Concomitant injuries; Fracture; Orthosis; Thoracic Spine; Trauma.

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Conflict of interest statement

None.

Figures

Figure 1:
Figure 1
rates of concomitant injury for TSFs from mechanical falls
Figure 2:
Figure 2
rates of concomitant injury for TSFs from fall from height
Figure 3:
Figure 3
rates of concomitant injury for TSFs from MVCs
Figure 4:
Figure 4
rates of concomitant injury for TSFs from MCCs
See this image and copyright information in PMC

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References

    1. Kumar R, Lim J, Mekary RA, Rattani A, Dewan MC, Sharif SY, Osorio-Fonseca E, Park KB. Traumatic Spinal Injury: Global Epidemiology and Worldwide Volume. World Neurosurg. 2018;113:e345–e363. doi: 10.1016/j.wneu.2018.02.033. May Epub 2018 Feb 14. PMID: 29454115. - DOI - PubMed
    1. Aghakhani K, Kordrostami R, Memarian A, Asl ND, Zavareh FN. The association between type of spine fracture and the mechanism of trauma: A useful tool for identifying mechanism of trauma on legal medicine field. J Forensic Leg Med. 2018;56:80–82. doi: 10.1016/j.jflm.2018.01.004. May Epub 2018 Feb 7. PMID: 29571167. - DOI - PubMed
    1. Thompson WL, Stiell IG, Clement CM, Brison RJ. Canadian C-Spine Rule Study Group. Association of injury mechanism with the risk of cervical spine fractures. CJEM. 2009;11(1):14–22. doi: 10.1017/s1481803500010873. Jan PMID: 19166635. - DOI - PubMed
    1. Shahriari M, Sadaghiani MS, Spina M, Yousem DM, Franck B. Traumatic lumbar spine fractures: Transverse process fractures dominate. Clin Imaging. 2021;71:44–48. doi: 10.1016/j.clinimag.2020.11.012. Mar Epub 2020 Nov 4. PMID: 33171366. - DOI - PubMed
    1. Cothren CC, Moore EE, Ray CE, Jr, Johnson JL, Moore JB, Burch JM. Cervical spine fracture patterns mandating screening to rule out blunt cerebrovascular injury. Surgery. 2007;141(1):76–82. doi: 10.1016/j.surg.2006.04.005. Jan Epub 2006 Aug 28. PMID: 17188170. - DOI - PubMed

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