Wang Hongwei, Xiang Qiang, Li Changqing, Zhou Yue
*Department of Orthopedics, Xinqiao Hospital †Department of Traumatology, Southwest Hospital, the Third Military Medical University, Chongqing, China.
J Spinal Disord Tech. 2013 Dec;26(8):E306-13. doi: 10.1097/BSD.0b013e3182886db9.
We retrospectively reviewed hospital records of all patients aged 18 years or older with traumatic cervical spinal fracture (TCSF) at 2 university-affiliated hospitals between January 2001 and December 2010 (n = 643); 417 patients (64.9%) presented with traumatic cervical spinal cord injury (TCSCI). The variables assessed included age, sex, mechanism of spinal fracture, anatomic distribution, America Spinal Injury Association (ASIA) impairment scale and associated injuries (ASOIs).
To describe the epidemiological characteristics of TCSF and risk factors for TCSCI in adults in Chongqing, China.
There were so many studies about the characteristics of spinal fractures and spinal cord injury, but the study about the traumatic spinal fracture and spinal cord injury among the cervical region and the relationship between the TCSF and cervical spinal cord injury is rare.
A total of 643 patients with TCSF were included in the study. The mean age was 42.5±13.8 years, with a range of 18-86 years, and the male/female ratio was 4.3:1. The mean annual incidence of TCSF was 65 cases per 100,000 hospital admissions. The leading cause of TCSF was motor vehicle accidents (MVA) (n = 213, 33.1%), followed by falls from a high height (n = 211, 32.8%). The most common injury site was C5, which accounted for 22.7% of cases. In all, 37 (5.8%) patients had complications, 204 patients (31.7%) had ASOIs, and 417 patients (64.9%) had TCSCI. There were significant differences in the etiology and distribution of fracture location between the patients with and without TCSCI. Young age (31-45 age group), male sex, high falls (≥2 m), and traumatic C5, C6 vertebra fractures were risk factors for TCSCI.
MVA and falls from a high height were the leading causes of TCSCI, especially young male patients with lower cervical spinal fractures. Therefore, establishing public policies aimed at preventing injuries should focus on MVA and falls from a high height, and more attention should be paid to the young male population.
我们回顾性分析了2001年1月至2010年12月期间两所大学附属医院中所有年龄在18岁及以上的创伤性颈椎骨折（TCSF）患者的医院记录（n = 643）；417例患者（64.9%）伴有创伤性颈脊髓损伤（TCSCI）。评估的变量包括年龄、性别、脊柱骨折机制、解剖分布、美国脊髓损伤协会（ASIA）损伤分级及相关损伤（ASOIs）。
描述中国重庆成人TCSF的流行病学特征及TCSCI的危险因素。
关于脊柱骨折和脊髓损伤特征的研究众多，但关于颈部创伤性脊柱骨折和脊髓损伤以及TCSF与颈脊髓损伤之间关系的研究较少。
本研究共纳入643例TCSF患者。平均年龄为42.5±13.8岁，年龄范围为18 - 86岁，男女比例为4.3:1。TCSF的年平均发病率为每10万例住院患者65例。TCSF的主要原因是机动车事故（MVA）（n = 213，33.1%），其次是高处坠落（n = 211，32.8%）。最常见的损伤部位是C5，占病例的22.7%。共有37例（5.8%）患者出现并发症，204例患者（31.7%）有ASOIs，417例患者（64.9%）有TCSCI。有TCSCI和无TCSCI患者在骨折病因和骨折部位分布上存在显著差异。年轻（31 - 45岁年龄组）、男性、高处坠落（≥2米）以及创伤性C5、C6椎体骨折是TCSCI的危险因素。
MVA和高处坠落是TCSCI的主要原因，尤其是伴有下颈椎骨折的年轻男性患者。因此，制定旨在预防损伤的公共政策应侧重于MVA和高处坠落，并且应更多关注年轻男性人群。
