Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
J Am Acad Orthop Surg. 2012;20 Suppl 1:S18-22. doi: 10.5435/JAAOS-20-08-S18.
Axial skeletal injury and related illness is a major cause of medical disability and force attrition in deployed service members. Predeployment identification of at-risk personnel is unreliable. Risk of axial skeletal injury or illness during deployment is heterogeneous. Major spinal trauma casualties are uncommon, accounting for 1% of casualties, and are usually related to battle injuries. These major spinal injuries are often associated with multiple system/anatomic injuries. Spinal cord injuries account for 18% of major spinal injuries in persons with battle-related spinal injury. Non-battle spine pain, that is, back or neck area pain not associated with major trauma, is a significant force attrition problem, accounting for 40% of all combat casualty evacuation in some years. Personnel attrition due to neck and back pain not associated with major trauma is highly variable by unit and exposure, including psychological exposure. Return-to-duty rates for both traumatic and atraumatic spine injuries is poor (≤15%); this rate is predicted by psychological comorbidities.
轴向骨骼损伤及相关疾病是部署中现役军人医疗残疾和战斗力减员的主要原因。部署前对高危人员的识别不可靠。部署期间发生轴向骨骼损伤或疾病的风险存在异质性。主要脊柱创伤伤员不常见，占伤员的 1%，通常与战斗伤有关。这些主要的脊柱损伤通常与多系统/解剖损伤有关。脊髓损伤占与战斗相关的脊柱损伤人员中主要脊柱损伤的 18%。非战斗性脊柱疼痛，即与重大创伤无关的背部或颈部区域疼痛，是一个严重的战斗力减员问题，在某些年份占所有战斗伤员后送的 40%。与重大创伤无关的颈部和背部疼痛导致的人员减员因单位和暴露而异，包括心理暴露。创伤性和非创伤性脊柱损伤的归队率都很差（≤15%）；这一比率由心理合并症预测。
