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. 2022 Jun;16(3):521-529.
doi: 10.14444/8244.

Seizure-Induced Spinal Fractures: A Systematic Review

Luis A Robles  1 , Amancio Guerrero-Maldonado  2
Affiliations

Seizure-Induced Spinal Fractures: A Systematic Review

Luis A Robles et al. Int J Spine Surg. 2022 Jun.

Abstract

Background: Patients with epilepsy have a higher risk of skeletal injuries, and some of these fractures occur in the spine during a seizure. Seizure-induced spinal fractures (SISF) are unusual injuries that typically occur in the thoracolumbar spine. Because these skeletal injuries are not well described in the literature, this article aims to analyze the characteristics of this uncommon clinical entity.

Methods: A PubMed and Scopus search adhering to preferred reporting items for systematic reviews and meta-analyses guidelines was performed to include studies reporting patients with SISF. The data gathered from this review were analyzed to characterize this condition.

Results: The search yielded 34 articles with a total of 38 patients with SISF. All studies were case reports (level 5 evidence). Most fractures occurred in the thoracic and lumbar spine, and the most common injuries were type A1 and A4 fractures according to the AO spine classification system. Different characteristics of SISF are described including demographics, clinical findings, imaging, and treatment.

Conclusions: SISF should be ruled out in patients who have a recent history of seizures and who report persistent dorsolumbar pain or neurological deficit. SISF usually occurs in the thoracolumbar spine and less frequently in the cervical spine. This review shows that different patterns of neurological deficits, some of them severe, may occur in approximately a quarter of patients with SISF.

Clinical relevance: This study provides awareness of an uncommon spine condition. Physicians should suspect SISF in patients with persistent dorsolumbar pain after a seizure.

Keywords: fractures related to epilepsy; fractures related to seizures; seizure-induced spinal fractures; spinal fractures related to convulsions; vertebral compression fractures.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of the literature search strategy and article selection for screening and analysis.
Figure 2
Figure 2
Bar chart showing the frequency of types of thoracolumbar fractures observed in this review. Different fracture patterns were observed in the same patient.
See this image and copyright information in PMC

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