Post-Traumatic Vertebral Injuries

Keywords: Spine, trauma, fracture, kinematics, vertebral fracture, spinal injury

Abstract

Introduction: Spinal injuries are common among young adult men. Recognizing kinematics can help reduce the number of late diagnoses, especially if there are consciousness disorders. Vertebral fractures can be single or multiple, and they are often associated with extravertebral injuries. Objectives: To examine the distribution of the lesion based on the mechanism of production, to characterize the neurological condition, to evaluate the lesion pattern and its relationship with extravertebral lesions, and to analyze the treatment. Materials and Methods: This was a multicenter, prospective study of patients admitted with post-traumavertebral injuries between July 1, 2018 and June 30, 2020. Age, gender, kinematics, neurological condition, affected sector, pattern of injury, and associated extravertebral injuries were all examined. Results: There were 281 patients (60% men) evaluated, with 400 vertebral and 118 extravertebral lesions. The causes were as follows: polytrauma in 62 cases, falls from great heights in 147 patients, and traffic accidents in 98. ASIA E was the most frequently observed neurological picture (8 cases), which was not determined at admission. The T2-L5 sector was the most affected, mostly by compression injuries. Head and chest trauma were the most common extravertebral injuries; there was one case of SCIWORA and one early death. Conclusions: The most commonly affected spinal sectors were thoracolumbar, thoracic, and lumbar; the injuries are typically caused by falls from great heights and, in general, are isolated, with no neurological injuries. The treatment is determined by the stability and neurological condition.

Downloads

Download data is not yet available.

Author Biographies

Pedro Luis Bazán, Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina.
Carlos Cortes Luengo, Spine Sector, Instituto Traumatológico de Santiago de Chile, Chile
Spine Sector, Instituto Traumatológico de Santiago de Chile, Chile
Álvaro Enrique Borri, Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Martín Medina, Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Spinal Pathology Unit, Orthopedics and Traumatology Service, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
Nicolás Maximiliano Ciccioli, Spine Sector, Clínica Pueyrredón, Mar del Plata, Buenos Aires, Argentina
Spine Sector, Clínica Pueyrredón, Mar del Plata, Buenos Aires, Argentina
Daiana Denise Poza Roman, Orthopedics and Traumatology Service, Hospital Municipal de Agudos “Dr. Leónidas Lucero”, Bahía Blanca, Buenos Aires, Argentina
Orthopedics and Traumatology Service, Hospital Municipal de Agudos “Dr. Leónidas Lucero”, Bahía Blanca, Buenos Aires, Argentina
Luis Patalano, Clínica de las Fracturas, Mar del Plata, Buenos Aires, Argentina
Clínica de las Fracturas, Mar del Plata, Buenos Aires, Argentina
Pablo Beltrán Moreno, Clínica de las Fracturas, Mar del Plata, Buenos Aires, Argentina
Clínica de las Fracturas, Mar del Plata, Buenos Aires, Argentina
Enrique Alcides Casco, Orthopedics and Traumatology Service, IPS Hospital, Asunción, Paraguay
Orthopedics and Traumatology Service, IPS Hospital, Asunción, Paraguay
Elio Marin, Orthopedics and Traumatology Service, IPS Hospital, Asunción, Paraguay
Orthopedics and Traumatology Service, IPS Hospital, Asunción, Paraguay
Alfredo Osvaldo Godoy Adaro, Spine Sector, Clínica Modelo S.A. Paraná, Entre Ríos, Argentina
Spine Sector, Clínica Modelo S.A. Paraná, Entre Ríos, Argentina
Edgar Enrique Gutierrez, Sanatorio Integral IOT, Posadas, Misiones, Argentina
Sanatorio Integral IOT, Posadas, Misiones, Argentina
Richard Alejandro Avero Gonzalez, Spine Sector, Sanatorio Modelo Quilmes, Buenos Aires, Argentina
Spine Sector, Sanatorio Modelo Quilmes, Buenos Aires, Argentina
Joel Darío Acevedo Yoga, “Carolina de Jesús” Medical Center, Santiago de los Caballeros, Dominican Republic
“Carolina de Jesús” Medical Center, Santiago de los Caballeros, Dominican Republic
José Carlos Soria Adaro, Spine Sector, Clínica Francesa, Mendoza, Argentina
Spine Sector, Clínica Francesa, Mendoza, Argentina
Sergio Terraza, Spine Sector, Clínica Francesa, Mendoza, Argentina
Spine Sector, Clínica Francesa, Mendoza, Argentina
Alex Belloni Barreto, Spine Sector, Hospital Británico, Montevideo, Uruguay
Spine Sector, Hospital Británico, Montevideo, Uruguay

References

Lenehan B, Boran S, Street J, Higgins T, McCormack D, Poynton AR. Demographics of acute admissions to a

National Spinal Injuries Unit. Eur Spine J 2009;18(7):938-42. https://doi.org/10.1007/s00586-009-0923-y

Heidari P, Zarei MR, Rasouli MR, Vaccaro AR, Rahimi-Movaghar V. Spinal fractures resulting from traumatic

injuries. Chin J Traumatol 2010;13(1):3-9. https://doi.org/10.3760/cma.j.issn.1008-1275.2010.01.001

Zulkipli Z, Faudzi M, Manap A, Paiman N. Non-fatal spine injuries resulting from motorcycle crashes. IATSS

Research 2018;42(3):121-7. https://doi.org/10.1016/j.iatssr.2017.09.001

Yadollahi M, Paydar S, Ghaem H, Ghorbani M, Mousavi SM, AkerdiATA, et al. Epidemiology of cervical spine

fractures. Trauma Mon 2016;21(3):e33608. https://doi.org/10.5812/traumamon.33608

Verheyden AP, Spiegl UJ, Ekkerlein H, Gercek EG, Hauck S, Joste C, et al. Treatment of fractures of the

thoracolumbar spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Global Spine J 2018;8(2 Suppl):34S-45S. https://doi.org/10.1177/2192568218771668

Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, et al. AOSpine thoracolumbar spine

injury classification system: fracture description, neurological status, and key modifiers. Spine (Phila Pa 1976)

;38(23):2028-37. https://doi.org/10.1097/BRS.0b013e3182a8a381

Vaccaro AR, Koerner JD, Radcliff KE, Oner FC, Reinhold M, Schnake KJ, et al. AO Spine subaxial cervical spine

injury classification system. Eur Spine J 2016;25(7):2173-84. https://doi.org/10.1007/s00586-015-3831-3

Vaccaro AR, Schroeder GD, Divi SN, Kepler CK, Kleweno CP, Krieg JC, et al. Description and reliability of the

AOSpine Sacral Classification System. J Bone Joint Surg Am 2020;102(16):1454-63. https://doi.org/10.2106/JBJS.19.01153

Bazán PL, Borri AE, Pesci P, Szmidt VE. Lesiones vertebrales y medulares en pacientes con caída de altura y lesión raquimedular. Rev Asoc Platense Ortop Traumatol 2006/2009:149-54.

Bazán PL, Borri AE, Szmidt VE. Accidente en vía pública y lesión raquimedular. Rev Asoc Platense Ortop

Traumatol 2006/2009:139-54.

Borri AE, Sanchez A, Lías A, Bazán PL, Szmidt VE. Diagnóstico y tratamiento de las lesiones traumáticas de la

columna toracolumbar y lumbar. Rev Asoc Platense Ortop Traumatol 2006/2009:117-24.

Bazan PL. Significance of SCIWORA in adult. Coluna/Columna 2015;14(2):134-7. https://doi.org/10.1590/S1808-1851201514020R130

Bazán PL, Borri AE, Medina M. Predictores en el cuadro SCIWORA del adulto. Coluna/Columna 2013;12(4):326-

https://doi.org/10.1590/S1808-18512013000400014

Bazán PL, Micchia NO, Schmidt D, Areco P, Re M, Casabone A, et al. Lesión medular post-traumática. Tratamiento multidisciplinario.Rev Asoc Platense Ortop Traumatol 2002/2005:201-6.

Kuo SCH, Kuo PJ, Rau CS, Chen YC, Hsieh HY, Hsieh CH. The protective effect of helmet use in motorcycle

and bicycle accidents: a propensity score-matched study based on a trauma registry system. BMC Public Health

;17(1):639. https://doi.org/10.1186/s12889-017-4649-1

Zileli M, Osorio-Fonseca E, Konovalov N, Cardenas-Jalabe C, Kaprovoy S, Mlyavykh S, et al. Early management

of cervical spine trauma: WFNS Spine Committee Recommendations. Neurospine 2020;17(4):710-22. https://doi.org//10.14245/ns.2040282.141

Smith JA, Siegel JH, Siddiqi SQ. Spine and spinal cord injury in motor vehicle crashes: A function of change in

velocity and energy dissipation on impact with respect to the direction of crash. J Trauma 2015;59(1):117-31.

https://doi.org/10.1097/01.TA.0000171534.75347.52

Roche SJ, Sloane PA, Mcabe JP. Epidemiology of spine trauma in an Irish regional trauma unit: a 4-year

study. Injury 2008;39(4):436-42. https://doi.org/10.1016/j.injury.2007.12.012

Driessen MLS, Sturms LM, van Zwet EW, Bloemers FW, Ten Duis HJ, Edwards MJR, et al. Evaluation of the

Berlin polytrauma definition: A Dutch nationwide observational study. J Trauma 2021;90(4):694-9.

https://doi.org/10.1097/TA.0000000000003071

Bazan PL, Bravo M, Gutierrez E, Terraza S, Cortes C, Borri Á, et al. Fracturas de la columna vertebral en pacientes con espondilitis anquilosante. Rev Asoc Argent Ortop Traumatol 2021;86(1):58-63. https://doi.org/10.15417/issn.1852-7434.2021.86.1.1094

Bazán PL, Ciccioli NM, Borri AE, Medina M. Fractura de columna torácica alta asociada a fractura de esternón.

Coluna/Columna 2017;16(1):60-3. https://doi.org/10.1590/S1808-18512017160115184

Bazán PL, Betemps A, Ciccioli N, Borri A, Medina M. Combination of upper thoracic fracture and sternum fracture. Global Spine J 2015;5(1_suppl):s-0035-1554442-s-0035-1554442. https://doi.org/10.1055/s-0035-1554442

Boden BP, Jarvis CG. Spinal injuries in sport. Neurol Clin 2008;26(1):63-78. https://doi.org/10.1016/j.ncl.2007.12.005

Bazán PL, Marin E, Betemps A, Borri ÁE, Romano Yalour N, Ciccioli NM, et al. Lesiones toracolumbares en la

práctica de acrobacia en tela. Reporte de casos. Rev Asoc Argent Ortop Traumatol 2020;85(2):119-24.

https://doi.org/10.15417/issn.1852-7434.2020.85.2.1010

Blumer CE, Quine S. Prevalencia de lesión de la médula espinal: una comparación internacional.

Neuroepidemiología 1995;14:258-68. https://doi.org/10.1159/000109801

Published
2023-04-24
How to Cite
Bazán, P. L., Cortes Luengo, C., Borri, Álvaro E., Medina, M., Ciccioli, N. M., Poza Roman, D. D., Patalano, L., Beltrán Moreno, P., Casco, E. A., Marin, E., Godoy Adaro, A. O., Gutierrez, E. E., Avero Gonzalez, R. A., Acevedo Yoga, J. D., Soria Adaro, J. C., Terraza, S., & Belloni Barreto, A. (2023). Post-Traumatic Vertebral Injuries. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(2), 138-147. https://doi.org/10.15417/issn.1852-7434.2023.88.2.1510
Section
Clinical Research

Most read articles by the same author(s)

1 2 > >>