Epidemiological Characteristics of Traumatic Spinal Cord Injuries in Multi-Center Retrospective Study in Northwest China, 2017-2020. (preprint)

Introduction: Traumatic spinal cord injuries (TSCI) are worldwide public health problems. There has been a lack of extensive multi-center study of TSCI epidemiology in Northwest China in pre- and post-pandemic period of COVID-19. Materials: and Methods: A multi-center retrospective study of 14 hospitals of Northwest China was conducted on patients with TSCI between 2017 and 2020. Variables assessed included patient demographics, etiology, segmental distribution, treatment, waiting time for treatment and outcomes. Results: : The number of patients with TSCI showed an increasing trend from 2017 to 2019 while there were fewer patients in 2020 than in 2019. The male-to-female ratio was 3.67:1 and the mean age was 48±14.9. The major cause of TSCI was high fall (38.8%), low fall (27.7%), traffic accidents (23.9%), sports (2.6%) and others (7.0%). The segmental distribution showed a bimodal pattern, peak segments were C6 and Tl1, L1(14.7%) was the most frequently injured segments. Incomplete injury (72.8%) occurred more often than complete injury (27.2%). ASIA scale of most patients did not change before and after treatment both in operational or conservative group. 975 patients from urban and 1646 patients from rural areas were conducted, most urban residents could rush to get treatment after injured immediately (<1 h), whereas most rural patients get treatment spend several hours since injured. The rough annual incidence from 2017-2020 are 112.4, 143.4,152.2 and 132.6 per million people calculated by the population-coverage-rate. Conclusion: The incidence of TSCI in Northwest China is high and growing. However, under the pandemic policy reasons, it has decreased in 2020. The promotion of online work may be an effective primary prevention measures for trauma. Also, due to the distance from the hospitals with proper conditions, rural patients need to spend long time to there, the timely treatment of them should be paid attention.

Consensus on standardized diagnosis and treatment for osteoporotic vertebral compression fracture patients during epidemic of corona virus disease 2019 / 中华创伤杂志

Since December 2019, the corona virus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (2019-nCoV) has been reported in Wuhan, Hubei Province. Almost 70% of patients susceptible to 2019-nCoV are over age of 50 years, with extremely large proportion of critical illness and death of the elderly patients. Meanwhile, the elderly patients are at high risk of osteoporotic fractures especially osteoporotic vertebral compression fractures (OVCF). During the prevention and control of COVID-19 epidemic, orthopedists are confronted with the following difficulties including how to screen and protect OVCF patients, how to accurately diagnose and assess the condition of OVCF patients with suspected or confirmed COVID-19, and how to develop reasonable treatment plans and comprehensive protective measures in emergency and outpatient clinics. In order to standardize the diagnosis and treatment of patients with OVCF diagnosed with COVID-19, the authors jointly develop this expert consensus. The consensus systematically recommends the standardized emergency and outpatient screening and confirmation procedures for OVCF patients with suspected or confirmed COVID-19 and protective measures for emergency and outpatient clinics. Moreover, the consensus describes the grading and classification of OVCF patients diagnosed with COVID-19 according to the severity of illness and recommends different treatment plans and corresponding protective measures based on the different types and epidemic prevention and control requirements.