Sharma Om P, Oswanski Michael F, Yazdi Joseph S, Jindal Steve, Taylor Michael
Department of Trauma Services, The Toledo Hospital & Toledo Children's Hospital, Toledo, Ohio, USA.
Am Surg. 2007 Jan;73(1):70-4.
An institutional review board-approved 8-year retrospective trauma registry analysis of cervical spine injuries (CSIs) was done in a Level 1 trauma center. This analysis includes 129 CSI patients (1.3% of trauma admissions). Cervical spine radiographs diagnosed injuries in 71 per cent of CSI patients. Cervical spine radiographs were false negative in 29 per cent of patients, who were found to have CSI on spine CT. Spine CT had 98 per cent sensitivity and detected 45 per cent additional injuries in cervical spine radiograph-positive patients. Spine CT scans were false negative in two patients with soft tissue injury. Cervical spine fractures were isolated in 45 per cent (n = 58) and multilevel in 55 per cent (n = 71) with contiguous fractures in 43 per cent (n = 55) of patients. Injuries involved two adjoining vertebrae in 38 patients and three or more adjoining vertebrae in 7 patients. C1-2 and C5-6 comprised 26 per cent and 20 per cent of all contiguous fractures. The least common was C7-T1, diagnosed in 2 per cent. The most common contiguous fractures were C1-2 in the elderly and C5-6 in children, comprising half of contiguous cervical injuries in the respective age groups. There were 26 (20.2%) noncontiguous injuries: 15 cervical and 11 cervicothoracolumbar. Multiple regions of the vertebral column were involved in 7.8 per cent of CSI patients. Spine CT is the preferred modality to assess CSI. Injuries were isolated in 45 per cent and were multilevel in the remaining CSI patients. Contiguous and noncontiguous injuries involving the cervical and thoracolumbar spine are common. Assessment of the entire spinal column should be done in patients with CSI.
在一家一级创伤中心，对颈椎损伤（CSI）进行了一项经机构审查委员会批准的为期8年的回顾性创伤登记分析。该分析纳入了129例CSI患者（占创伤入院患者的1.3%）。颈椎X线片诊断出71%的CSI患者存在损伤。颈椎X线片在29%的患者中为假阴性，这些患者经脊柱CT检查发现存在CSI。脊柱CT的敏感性为98%，在颈椎X线片阳性的患者中检测出45%的额外损伤。脊柱CT扫描在2例软组织损伤患者中为假阴性。颈椎骨折单发的占45%（n = 58），多发的占55%（n = 71），其中43%（n = 55）的患者骨折相邻。38例患者的损伤累及两个相邻椎体，7例患者的损伤累及三个或更多相邻椎体。C1 - C2和C5 - C6分别占所有相邻骨折的26%和20%。最不常见的是C7 - T1，占2%。最常见的相邻骨折在老年人中是C1 - C2，在儿童中是C5 - C6，分别占各年龄组相邻颈椎损伤的一半。有26例（20.2%）非相邻损伤：15例为颈椎损伤，11例为颈胸腰椎损伤。7.8%的CSI患者脊柱多个区域受累。脊柱CT是评估CSI的首选方式。45%的损伤为单发，其余CSI患者为多发损伤。涉及颈椎和胸腰椎的相邻和非相邻损伤很常见。对于CSI患者，应评估整个脊柱。
