Spinal fractures and/or spinal cord injuries are associated with orthopedic and internal organ injuries in proximity to the spinal injury

North American Spine Society Journal (NASSJ), 2021 · DOI: https://doi.org/10.1016/j.xnsj.2021.100057 · Published: March 21, 2021

Spinal Cord Injury Trauma Orthopedics

Simple Explanation

This study examines the patterns of injuries that occur alongside spinal fractures and spinal cord injuries. The study found that injuries to other bones and internal organs often happen near the site of the spinal injury. The study highlights the importance of carefully checking for these related injuries to improve patient care and outcomes.

Study Duration

2011-2015

Participants

520,183 patients with acute spinal injury

Evidence Level

Not specified

Key Findings

1
Associated bony and internal organ injuries were common, occurring in 63% of cervical spine injury patients, 79% of thoracic spine injury patients, and 71% of lumbar spine injury patients.
2
Injuries were most common in the local area of the primary spinal injury.
3
Increased injury severity was strongly correlated with increased mortality.

Research Summary

The current study revealed spinal fractures and/or cord injuries had high incidences of associated injuries that had a predominance of local distribution. These ﬁndings, in combination with the mortality analysis, demonstrate the importance of local targeted evaluations for associated injuries. Clinicians should be aware of the epidemiology and injury pattern of spinal trauma as injury severity and concurrent injuries have been shown to have strong associations with mortality.

Practical Implications

Targeted Evaluations

The study emphasizes the importance of local, targeted evaluations for associated injuries to improve patient outcomes.

Clinical Suspicion

Clinicians should maintain a higher index of suspicion for spinal trauma in patients presenting with common mechanisms of injury.

Thorough Trauma Evaluation

The study highlights the need for thorough trauma evaluations, especially for patients with known lumbar injuries, to identify intracranial injuries.

Study Limitations

1
Dataset quality, particularly administratively coded data.
2
The present study does not utilize NTDB data coded in the ICD-10 format, to avoid ICD-9/10 code crossover.
3
The NTDB lacks some important demographic variables including race, geographic region, and urban/rural classiﬁcation.

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