PMID- 35141623
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220902
IS  - 2666-5484 (Electronic)
IS  - 2666-5484 (Linking)
VI  - 6
DP  - 2021 Jun
TI  - Spinal fractures and/or spinal cord injuries are associated with orthopedic and 
      internal organ injuries in proximity to the spinal injury.
PG  - 100057
LID - 10.1016/j.xnsj.2021.100057 [doi]
LID - 100057
AB  - BACKGROUND: the demographics, mechanisms of injury, and concurrent injuries 
      associated with cervical, thoracic and lumbar spinal fracture and/or spinal cord 
      injury remain poorly characterized. METHODS: Patients aged 18 and older with 
      spinal injury between 2011 and 2015 in the National Trauma Data Bank (NTDB) were 
      identified. Patient demographics, comorbidity burden, mechanism of injury, and 
      associated injuries were analyzed. RESULTS: in total, 520,183 patients with acute 
      spinal injury were identified including 216,522 cervical, 191,218 thoracic, and 
      220,294 lumbar. The age distributions were trimodal with peaks in incidence at 
      around 2155 and a lesser peak around 85 years of age. The number of comorbidities 
      increased while injury severity decreased with advancing patient age. Motor 
      vehicle accidents (MVAs) were the most common mechanism of injury. Associated 
      bony and internal organ injuries were common and occurred in 63% of cervical 
      spine injury patients, 79% of thoracic spine injury patients, and 71% of lumbar 
      spine injury patients. In all three sub-populations, there was a predominance of 
      injuries in the local area of the primary injury. For cervical, these were rib 
      injuries (28%), thoracic spine injuries (22%), skull fractures (20%), 
      intracranial injuries (26%) and lung injuries (21%). For thoracic, these were rib 
      injuries (47%), lumbar spine injuries (26%), cervical spine injuries (25%), lung 
      injuries (35%) and intracranial injuries (24%). For lumbar, these were rib 
      injuries (38%), thoracic spine injuries (22%), pelvic fractures (20%), lung 
      injuries (26%) and intracranial injuries (19%). Multivariate regression analysis 
      demonstrated that increased injury severity was strongly correlated with 
      increased mortality, with lesser contributions from increased age and comorbidity 
      burden. CONCLUSIONS: 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.
CI  - (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of North American Spine 
      Society.
FAU - Anandasivam, Nidharshan S
AU  - Anandasivam NS
AD  - Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 
      Howard Avenue, New Haven, CT 06510, United States.
FAU - Ondeck, Nathaniel T
AU  - Ondeck NT
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St., 
      New York, NY 10021, United States.
FAU - Bagi, Paul S
AU  - Bagi PS
AD  - Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 
      Howard Avenue, New Haven, CT 06510, United States.
FAU - Galivanche, Anoop R
AU  - Galivanche AR
AD  - Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 
      Howard Avenue, New Haven, CT 06510, United States.
FAU - Samuel, Andre M
AU  - Samuel AM
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St., 
      New York, NY 10021, United States.
FAU - Bohl, Daniel D
AU  - Bohl DD
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, 1611W. 
      Harrison St, Suite 400, Chicago, IL 60612, United States.
FAU - Grauer, Jonathan N
AU  - Grauer JN
AD  - Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 
      Howard Avenue, New Haven, CT 06510, United States.
LA  - eng
GR  - T35 AG049685/AG/NIA NIH HHS/United States
GR  - UL1 TR001863/TR/NCATS NIH HHS/United States
PT  - Journal Article
DEP - 20210321
PL  - United States
TA  - N Am Spine Soc J
JT  - North American Spine Society journal
JID - 9918335076906676
PMC - PMC8820026
OTO - NOTNLM
OT  - Associated injuries
OT  - Injury severity
OT  - Mechanism of injury
OT  - Mortality
OT  - Spinal cord injury
OT  - Spine fracture
OT  - Spine trauma
COIS- The authors declare that they have no known competing financial interests or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2022/02/11 06:00
MHDA- 2022/02/11 06:01
PMCR- 2021/03/21
CRDT- 2022/02/10 05:40
PHST- 2020/12/24 00:00 [received]
PHST- 2021/03/13 00:00 [revised]
PHST- 2021/03/17 00:00 [accepted]
PHST- 2022/02/10 05:40 [entrez]
PHST- 2022/02/11 06:00 [pubmed]
PHST- 2022/02/11 06:01 [medline]
PHST- 2021/03/21 00:00 [pmc-release]
AID - S2666-5484(21)00009-3 [pii]
AID - 100057 [pii]
AID - 10.1016/j.xnsj.2021.100057 [doi]
PST - epublish
SO  - N Am Spine Soc J. 2021 Mar 21;6:100057. doi: 10.1016/j.xnsj.2021.100057. 
      eCollection 2021 Jun.