Epidemiologic analysis of traumatic spinal fractures / 中华创伤杂志

ABSTRACT

Objective To analyze the epidemiologic features of traumatic spinal fracture so as to improve its prevention and treatment levels.Methods A total of 1393 patients with spinal fractures(955 males,438 females,at age range of 4-89 years,mean 45.5 years)treated between May 2001 and May 2011 were reviewed to statistically analyze their epidemiologic characteristics.Results The age of all the patients was mainly focused at 30-49 years,accounting for 49.7％(692/1393).Males exceeded females in number among the five age groups below 59 years old,but the opposite tendency appeared in the two age groups above 60 years old.Fall from height and traffic accidents were the main injury causes,which accounted for 59.4％(827/1393).Among 1963 injury segments,cervical vertebral injury,thoracic vertebral injury,lumbar vertebral injury,sacrum and coccyx injury accounted for 23.8％(468/1963),31.9％(627/1963),43.9％(861/1963)and 0.4％(7/1963)respectively.Spinal fractures occurred largely in thoracolumbar segment(T10-L2),which accounted for 55.4％(1087/1963),and L1,T12 and L2 occupied 22.5％(441/1963),5.4％(303/1963),11.1％(218/1963)respectively.The predilection sites of fractures in cervical vertebrae were C2(6.4％,123/1963),C5(5.3％,105/1963)and C6(4.0％,78/1963)respectively.Of the patients with multiple level spinal fractures,the injury resulted from fall from height and traffic accidents accounted for 35.9 ％(78/217)and 17.1％(37/217)respectively.Of the patients with combined injury,the injury caused by fall from height and traffic accidents occupied 48.1％(176/366)and 25.1％(92/366)respectively.According to the American Spinal Injury Association(ASIA)scale,the injury degree of all the patients was mainly grade E(52.6％,733/1393),D(21.0％,293/1393)and A(15.3％,213/1393).A total of 1038 patients had surgical treatment.Their spinal function was mainly graded as level E(48.0％,498/1038),D(22.2％,231/1038)and A(17.1％,177/1038)pre-operatively,but the rates of patients with level E spinal function increased to 56.6％(588/1038)three weeks post-operatively.Conclusions The epidemiologic survey reveals that fall from height and traffic accidents are the main factors for spinal fractures and can easily lead to multi-level spinal fractures and systematic complications.Thereby,prevention and treatment methods should be designed according to the injury characteristics.