University of Edinburgh and Department of Neurosurgery, Western General Hospital, Edinburgh, EH4 2XU, UK.
Neurosurg Rev. 2020 Feb;43(1):69-77. doi: 10.1007/s10143-018-0988-3. Epub 2018 Jun 7.
The biomechanical relationship between cranial and spinal structures makes concomitant injury likely. Concomitant cranio-spinal injuries are important to consider following trauma due to the serious consequences of a missed injury. The objective of this review was to estimate the prevalence of concomitant cranio-spinal injury in the adult trauma population. A systematic search of MEDLINE and EMBASE databases to identify observational studies reporting the prevalence of concomitant cranio-spinal injury in the general adult trauma population was conducted on 21 March 2017. The prevalence of concomitant cervical spinal injury in patients with a traumatic brain injury (TBI); the prevalence of concomitant spinal injury in patients with a TBI; the prevalence of concomitant TBI in patients with a cervical spinal injury; and the prevalence of concomitant TBI in patients with a spinal injury were calculated by meta-analysis. Twenty-one studies met the inclusion criteria and were included in this review. The prevalence of concomitant cervical spinal injury in patients with a TBI was found to be 6.5% (95% CI 6.0-7.1%); the prevalence of concomitant spinal injury in patients with a TBI to be 12.4-12.5%; the prevalence of concomitant TBI in patients with a cervical spinal injury to be 40.4% (95% CI 33.0-48.0%); and the prevalence of concomitant TBI in patients with a spinal injury to be 32.5% (95% CI 10.8-59.3%). This review reports the prevalence of concomitant cranio-spinal injury and highlights the importance of considering concomitant injury in patients with a cranial or spinal traumatic injury.
颅与脊柱结构的生物力学关系使得同时发生损伤的可能性增加。由于漏诊损伤会带来严重后果，因此在创伤后需要考虑同时发生的颅-脊柱损伤。本综述的目的是评估成人创伤患者中同时发生颅-脊柱损伤的发生率。2017 年 3 月 21 日，对 MEDLINE 和 EMBASE 数据库进行了系统检索，以确定报告一般成人创伤人群中同时发生颅-脊柱损伤发生率的观察性研究。对颅脑损伤（TBI）患者中同时发生颈椎脊髓损伤的发生率；TBI 患者中同时发生脊髓损伤的发生率；颈椎脊髓损伤患者中同时发生 TBI 的发生率；以及脊髓损伤患者中同时发生 TBI 的发生率进行了荟萃分析。有 21 项研究符合纳入标准并被纳入本综述。TBI 患者中同时发生颈椎脊髓损伤的发生率为 6.5%（95%CI 6.0-7.1%）；TBI 患者中同时发生脊髓损伤的发生率为 12.4-12.5%；颈椎脊髓损伤患者中同时发生 TBI 的发生率为 40.4%（95%CI 33.0-48.0%）；脊髓损伤患者中同时发生 TBI 的发生率为 32.5%（95%CI 10.8-59.3%）。本综述报告了同时发生颅-脊柱损伤的发生率，并强调了在有颅或脊柱创伤性损伤的患者中考虑同时发生损伤的重要性。
