Clinical Analysis of Combined Head and Spine Trauma

ABSTRACT

Among 1350 craniocerebral trauma patients treated between January 1992 and December 1995. The authors analyzed 25 who had suffered combined head and spine trauma and had been subject to follow up. The ratio of males to females was 4 : 1 ; their ages ranged from less than twenty to over sixty. As clinical parameters, we use of the Glasgow Coma Scale(GCS), Revised Trauma Score(RTS) and Glasgow Outcome Scale(GOS) at discharge, and for clinical statistics, used the chi-square test. The results of the study were as follows : 1) Among craniocerebral trauma patients, the incidence of combined head and spine trauma was 2%(25/1350). 2) In cases with combined craniospinal trauma, the incidence of intracranial hemorrhage and cervical spine injury was 76% and 68%, respectively. 3) Among cases with spinal injury, head trauma combined with cervical spine injury showed the worst outcome (p<0.05). 4) Combined high cervical spine injury showed a poorer outcome than did lower cervical spine injury(p<0.05). 5) Initial GCS was significantly related to initial RTS(p<0.05). 6) At discharge, there was a very highly significant correlation between initial GCS and GOS(p<0.01), but not between initial RTS and GOS(p<0.081). 7) Especially in patients who are unconscious because of head trauma, it is important to investigate the possibility of spinal injury other than that of at cervical level.