Cervical spine injuries requiring surgery in a Level I trauma centre in a major German city.
Cervical spine
Incidence
Injury
Neurology
Surgery
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
09
07
2021
accepted:
10
10
2021
pubmed:
28
10
2021
medline:
27
1
2022
entrez:
27
10
2021
Statut:
ppublish
Résumé
Cervical spine injuries (CSI) are rare in trauma patients, at about 9.2-16.5/100,000 inhabitants in Scandinavia and Canada, and the annual incidence of CSI surgeries in Norway is around 3.0/100,000 inhabitants. However, despite their rarity, the incidence of CSI has increased, thereby assuming an increasing need for surgery. Outside of Scandinavia, no data about the incidence of CSI and subsequent surgeries exist. Therefore, this study aimed to analyse CSI epidemiology and surgery in a German city with a Level I trauma centre both to understand the injury and improve needs-based planning. This retrospective, monocentre study included all patients who presented with CSI from 2012-2017 at a university hospital with a Level I trauma centre in a major German city and had permanent residency within the city. Based on the assumption that the patients represented all CSI injuries in the city, as they were treated at the only available Level I trauma centre, the annual incidence of surgeries and neurologic deficits due to CSI were calculated. A total of 465 patients with 609 CSI were identified. Of these patients, 61 both received surgery and resided in the city (mean age, 68.1 ± 18.3 years; 26 female, 35 male). The incidence of CSI surgeries was calculated as 3.24/100,000 person years (1.75/100,000 in the upper and 1.54/100,000 in the subaxial cervical spine). Neurologic deficits occurred in 0.64/100,000 person years. The incidence of both surgeries and neurologic deficits showed no significant changes over the 6-year study period. Compared to Scandinavia, an increasing annual incidence for CSI surgeries and neurologic deficits were found. For long-term demand planning with adaptability to demographic changes, cross-regional studies including long-term follow-up are necessary.
Sections du résumé
BACKGROUND
Cervical spine injuries (CSI) are rare in trauma patients, at about 9.2-16.5/100,000 inhabitants in Scandinavia and Canada, and the annual incidence of CSI surgeries in Norway is around 3.0/100,000 inhabitants. However, despite their rarity, the incidence of CSI has increased, thereby assuming an increasing need for surgery. Outside of Scandinavia, no data about the incidence of CSI and subsequent surgeries exist. Therefore, this study aimed to analyse CSI epidemiology and surgery in a German city with a Level I trauma centre both to understand the injury and improve needs-based planning.
METHODS
This retrospective, monocentre study included all patients who presented with CSI from 2012-2017 at a university hospital with a Level I trauma centre in a major German city and had permanent residency within the city. Based on the assumption that the patients represented all CSI injuries in the city, as they were treated at the only available Level I trauma centre, the annual incidence of surgeries and neurologic deficits due to CSI were calculated.
RESULTS
A total of 465 patients with 609 CSI were identified. Of these patients, 61 both received surgery and resided in the city (mean age, 68.1 ± 18.3 years; 26 female, 35 male). The incidence of CSI surgeries was calculated as 3.24/100,000 person years (1.75/100,000 in the upper and 1.54/100,000 in the subaxial cervical spine). Neurologic deficits occurred in 0.64/100,000 person years. The incidence of both surgeries and neurologic deficits showed no significant changes over the 6-year study period.
CONCLUSIONS
Compared to Scandinavia, an increasing annual incidence for CSI surgeries and neurologic deficits were found. For long-term demand planning with adaptability to demographic changes, cross-regional studies including long-term follow-up are necessary.
Identifiants
pubmed: 34704140
doi: 10.1007/s00701-021-05029-1
pii: 10.1007/s00701-021-05029-1
pmc: PMC8761159
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-41Informations de copyright
© 2021. The Author(s).
Références
Alker GJ, Oh YS, Leslie EV, Lehotay J, Panaro VA, Eschner EG (1975) Postmortem radiology of head neck injuries in fatal traffic accidents. Radiology 114:611–617. https://doi.org/10.1148/114.3.611
doi: 10.1148/114.3.611
pubmed: 1118566
Brolin K, von Holst H (2002) Cervical injuries in Sweden, a national survey of patient data from 1987 to 1999. Inj Control Saf Promot 9:40–52. https://doi.org/10.1076/icsp.9.1.40.3318
doi: 10.1076/icsp.9.1.40.3318
pubmed: 12462163
Bucholz RW, Burkhead WZ, Graham W, Petty C (1979) Occult cervical spine injuries in fatal traffic accidents. J Trauma 19:768–771. https://doi.org/10.1097/00005373-197910000-00009
doi: 10.1097/00005373-197910000-00009
pubmed: 490692
Clayton JL, Harris MB, Weintraub SL, Marr AB, Timmer J, Stuke LE, McSwain NE, Duchesne JC, Hunt JP (2012) Risk factors for cervical spine injury. Injury 43:431–435. https://doi.org/10.1016/j.injury.2011.06.022
doi: 10.1016/j.injury.2011.06.022
pubmed: 21726860
Dowdell J, Kim J, Overley S, Hecht A (2018) Biomechanics and common mechanisms of injury of the cervical spine. Handb Clin Neurol 158:337–344. https://doi.org/10.1016/B978-0-444-63954-7.00031-8
doi: 10.1016/B978-0-444-63954-7.00031-8
pubmed: 30482361
Fredo HL, Bakken IJ, Lied B, Ronning P, Helseth E (2014) Incidence of traumatic cervical spine fractures in the Norwegian population: a national registry study. Scand J Trauma Resusc Emerg Med 22:78. https://doi.org/10.1186/s13049-014-0078-7
doi: 10.1186/s13049-014-0078-7
pubmed: 25520042
pmcid: 4299554
Fredo HL, Rizvi SA, Lied B, Ronning P, Helseth E (2012) The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway. Scand J Trauma Resusc Emerg Med 20:85. https://doi.org/10.1186/1757-7241-20-85
doi: 10.1186/1757-7241-20-85
pubmed: 23259662
pmcid: 3546896
Hu R, Mustard CA, Burns C (1996) Epidemiology of incident spinal fracture in a complete population. Spine 21:492–499. https://doi.org/10.1097/00007632-199602150-00016
doi: 10.1097/00007632-199602150-00016
pubmed: 8658254
Jackson AB, Dijkers M, Devivo MJ, Poczatek RB (2004) A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil 85:1740–1748. https://doi.org/10.1016/j.apmr.2004.04.035
doi: 10.1016/j.apmr.2004.04.035
pubmed: 15520968
Kamravan HR, Haghnegahdar A, Paydar S, Khalife M, Sedighi M, Ghaffarpasand F (2014) Epidemiological and clinical features of cervical column and cord injuries; a 2-year experience from a large trauma center in southern Iran. Bull Emerg Trauma 2:32–37
pubmed: 27162861
pmcid: 4771257
Leucht P, Fischer K, Muhr G, Mueller EJ (2009) Epidemiology of traumatic spine fractures. Injury 40:166–172. https://doi.org/10.1016/j.injury.2008.06.040
doi: 10.1016/j.injury.2008.06.040
pubmed: 19233356
Lomoschitz FM, Blackmore CC, Mirza SK, Mann FA (2002) Cervical spine injuries in patients 65 years old and older: epidemiologic analysis regarding the effects of age and injury mechanism on distribution, type, and stability of injuries. AJR Am J Roentgenol 178:573–577. https://doi.org/10.2214/ajr.178.3.1780573
doi: 10.2214/ajr.178.3.1780573
pubmed: 11856676
Passias PG, Poorman GW, Segreto FA, Jalai CM, Horn SR, Bortz CA, Vasquez-Montes D, Diebo BG, Vira S, Bono OJ, De La Garza-Ramos R, Moon JY, Wang C, Hirsch BP, Zhou PL, Gerling M, Koller H, Lafage V (2018) Traumatic fractures of the cervical spine: analysis of changes in incidence, cause, concurrent injuries, and complications among 488,262 patients from 2005 to 2013. World Neurosurg 110:e427–e437. https://doi.org/10.1016/j.wneu.2017.11.011
doi: 10.1016/j.wneu.2017.11.011
pubmed: 29138069
Pishnamaz M, Curfs I, Uhing D, Herren C, van Santbrink H, Mueller CA, Scholz M, Lichte P, Rijkers K, Boselie TF, Hildebrand F, Willems PC, Kobbe P (2019) Two-nation comparison of classification and treatment of subaxial cervical spine fractures: an internet-based multicenter study among spine surgeons. World Neurosurg 123:e125–e132. https://doi.org/10.1016/j.wneu.2018.11.078
doi: 10.1016/j.wneu.2018.11.078
pubmed: 30465953
Ryan MD, Henderson JJ (1992) The epidemiology of fractures and fracture-dislocations of the cervical spine. Injury 23:38–40. https://doi.org/10.1016/0020-1383(92)90123-a
doi: 10.1016/0020-1383(92)90123-a
pubmed: 1541497
Wang H, Xiang Q, Li C, Zhou Y (2013) Epidemiology of traumatic cervical spinal fractures and risk factors for traumatic cervical spinal cord injury in China. J Spinal Disord Tech 26:E306-313. https://doi.org/10.1097/BSD.0b013e3182886db9
doi: 10.1097/BSD.0b013e3182886db9
pubmed: 23429308