Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520, USA.
Spine (Phila Pa 1976). 2011 Sep 1;36(19):1532-40. doi: 10.1097/BRS.0b013e3181f550a6.
Retrospective medical record review.
The purpose of this study was to describe the incidence of other injuries that commonly occur in conjunction with cervical spine fractures and dislocations.
Cervical spine fractures are often associated with other significant traumatic conditions, which may also require prompt diagnosis and management. However, the relative incidences of the injuries that occur in conjunction with various cervical spine fractures have not been well documented.
The radiographic reports of all patients who underwent CT scans of the cervical spine at a single level 1 trauma center over a 10-year period were reviewed. The medical records of individuals with acute, nonpenetrating fractures of the cervical spine were further assessed for any associated traumatic pathology including noncontiguous spine injuries and those affecting other organ systems (i.e., head and neck, intrathoracic, intra-abdominal/pelvic, and nonspinal orthopedic disorders).
A total of 13,896 CT scans of the cervical spine were performed during this 10-year period of which 492 revealed acute fractures and/or dislocations. Of these subjects, 60% had sustained at least one additional injury. Overall, 57% were noted to have extraspinal injuries (34% head and neck, 17% intrathoracic, 10% intra-abdominal/pelvic, and 30% nonspinal orthopedic conditions) and noncontiguous spinal trauma was present in 19% of these cases (8% cervical injuries, 8% thoracic, and 6% lumbar). In general, the rates of associated injuries observed with occipital condyle and C7 fractures were significantly higher than those recorded for other cervical segments.
For patients with a known history of cervical spine trauma, the frequencies of associated injuries were similar across all levels of the cervical spine with the exception of the injuries to the craniocervical junctions. In practice, this means that injuries to the cervical spine can likely be grouped together when considering other possible associated injuries. Further elucidation of these injury patterns will likely be useful for facilitating the expedient evaluation and proper management of these individuals.
回顾性病历回顾。
本研究旨在描述与颈椎骨折和脱位同时发生的常见其他损伤的发生率。
颈椎骨折常与其他严重创伤情况相关，这些情况可能也需要及时诊断和治疗。然而，与各种颈椎骨折同时发生的损伤的相对发生率尚未得到很好的记录。
对在一家一级创伤中心进行颈椎 CT 扫描的所有患者的放射报告进行了回顾。对有急性、非穿透性颈椎骨折的个体的病历进行了进一步评估，以确定是否存在任何相关的创伤性病变，包括非连续脊柱损伤和影响其他器官系统（即头颈部、胸内、腹内/盆腔和非脊柱骨科疾病）的损伤。
在这 10 年期间共进行了 13896 次颈椎 CT 扫描，其中 492 次显示急性骨折和/或脱位。在这些患者中，60%至少有一处其他损伤。总体而言，57%的患者存在脊柱外损伤（34%头颈部，17%胸内，10%腹内/盆腔，30%非脊柱骨科疾病），19%的患者存在非连续脊柱创伤（8%颈椎损伤，8%胸段和 6%腰段）。一般来说，与枕骨髁和 C7 骨折相关的损伤发生率明显高于其他颈椎节段。
对于有已知颈椎创伤史的患者，除颅颈交界处损伤外，颈椎各节段的相关损伤频率相似。在实践中，这意味着在考虑其他可能的相关损伤时，颈椎损伤可能可以归为一组。进一步阐明这些损伤模式可能有助于促进对这些患者的快速评估和适当管理。
