PMID- 27787377
OWN - NLM
STAT- MEDLINE
DCOM- 20170209
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 43
DP  - 2016 Oct
TI  - Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 
      years: A retrospective observational study.
PG  - e5205
LID - 10.1097/MD.0000000000005205 [doi]
LID - e5205
AB  - To investigate the incidence and pattern of patients managed for traumatic upper 
      cervical spinal fractures (TUCSFs) in teaching hospitals in China over 13 
      years.We retrospectively reviewed 351 patients with TUCSF admitted to our 
      teaching hospitals. Incidence rates were calculated with respect to age, gender, 
      etiologies of trauma, anatomical distribution, anatomical classification, 
      American spinal injury association impairment scale (ASIA) classification of 
      neurological deficit and associated injuries.There were 260 male and 91 female 
      patients, with a mean age of 44.2 +/- 16.3 years. The mean age of the patients 
      significantly increased by year of admission, from 35.2 +/- 14.5 years to 
      47.5 +/- 17.2 years (P = 0.005). Motor vehicle accidents (MVAs) (n = 132, 37.6%) 
      and high falls (n = 104, 29.6%) were the 2 most common mechanisms. The number of 
      C2 fractures (n = 300, 85.5%) was significantly higher than that of C1 (n = 99, 
      28.2%) (P < 0.001). High falls resulted in significantly more Type I C1 fractures 
      than other etiologies (all P < 0.001). MVAs resulted in many more Type II and 
      Type III C1 fractures and Type II and Type III C2 fractures than other 
      etiologies. High falls were the most common injury type (n = 44, 36.4%) resulting 
      in neurological deficits. Patients who presented with Landell classification Type 
      I single C1 fracture (n = 6, 42.9%) had the highest rate of neurological 
      deficits. Eighty-two patients had combined injuries; the most common pattern was 
      cervical + cervical spine (n = 44, 12.5%), followed by cervical + thoracic spine 
      (n = 27, 7.7%). A total of 121 patients (34.5%) suffered neurological deficits. 
      Of all patients with TUCSF without combined injuries, single C2 fractures 
      accounted for the highest rate of neurological deficits (n = 62, 32.0%). 
      Multivariate logistic regression analysis indicated that sex (OR = 1.876, 95% CI: 
      1.022-3.443, P = 0.042), etiology (MVA pedestrians vs high fall: OR = 0.187, 95% 
      CI: 0.056-0.629, P = 0.007), level (C1 + OFs vs C1: OR = 6.264, 95% CI: 
      1.152-34.045, P = 0.034), and injury severity scoring (ISS) (OR = 1.186, 95% CI: 
      1.133-1.242, P < 0.001) were independent risk factors of neurological deficit.The 
      most common causes of TUCSF were MVAs and high falls; single C2 fractures without 
      combined injuries accounted for the most common neurological deficits. Different 
      etiologies resulted in different specific anatomical injuries and neurological 
      deficits. We should make early diagnoses and initiate timely treatment according 
      to different TUCSF patterns.
FAU - Wang, Hongwei
AU  - Wang H
AD  - Department of Orthopedics, General Hospital of Shenyang Military Area Command of 
      Chinese PLA, Shenyang, Liaoning Department of Radiology, Southwest Hospital 
      Department of Orthopedics, Xinqiao Hospital, the Third Military Medical 
      University, Chongqing State Key Laboratory of Robotics, Shenyang Institute of 
      Automation, Chinese Academy of Science, Shenyang, Liaoning, China.
FAU - Ou, Lan
AU  - Ou L
FAU - Zhou, Yue
AU  - Zhou Y
FAU - Li, Changqing
AU  - Li C
FAU - Liu, Jun
AU  - Liu J
FAU - Chen, Yu
AU  - Chen Y
FAU - Yu, Hailong
AU  - Yu H
FAU - Wang, Qi
AU  - Wang Q
FAU - Zhao, Yiwen
AU  - Zhao Y
FAU - Han, Jianda
AU  - Han J
FAU - Xiang, Liangbi
AU  - Xiang L
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cervical Vertebrae/*injuries
MH  - Female
MH  - *Forecasting
MH  - Hospitalization/*trends
MH  - Hospitals, Teaching/*statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Spinal Fractures/*epidemiology
MH  - Young Adult
PMC - PMC5089106
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2016/10/28 06:00
MHDA- 2017/02/10 06:00
PMCR- 2016/10/28
CRDT- 2016/10/28 06:00
PHST- 2016/10/28 06:00 [pubmed]
PHST- 2017/02/10 06:00 [medline]
PHST- 2016/10/28 06:00 [entrez]
PHST- 2016/10/28 00:00 [pmc-release]
AID - 00005792-201610250-00025 [pii]
AID - 10.1097/MD.0000000000005205 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Oct;95(43):e5205. doi: 10.1097/MD.0000000000005205.