National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
Surgeon. 2024 Dec;22(6):358-363. doi: 10.1016/j.surge.2024.07.007. Epub 2024 Jul 31.
Vertebral artery injuries (VAI) can occur due to cervical spine trauma. VAI can prove a serious complication and potentially compromise vascular supply to the posterior aspect of the brain. Currently, there is a paucity of evidence with regards to incidence, management, and outcomes for these patients. The purpose of this study is to investigate and elucidate the incidence of VAI associated with cervical trauma at a national tertiary referral centre for spinal pathology, their respective management, and associated outcomes.
A retrospective review was conducted from 2012 to 2021 to identify patients with VAI secondary to cervical spine trauma. Demographic, clinical, and radiological data was collected to identify common traits in injury characteristics and management.
1013 spine patients presented to our institution across the 10-year period. 739/1013 (72.9 %) were trauma patients. 42/739 (5.7 %) were imaged for suspected VAI secondary to trauma. There were 14/739 (1.9 %) confirmed VAI. All patients had CT-angiography for diagnosis. Four of the confirmed VAI patients (28.6 %) had additional MR-angiography imaging. Right-side was the most common side of VAI injury (7/14; 50 %), followed by left (5/14; 35.7 %) and bilateral (2/14; 14.3 %) injuries. 8/14 (57.1 %) patients were prescribed anti-thrombotic therapy. Acute mortality within 3-months was noted to be 2/14 (14.3 %) and occurred at 49 days and 57 days respectively.
VAI associated with cervical spine injury is rare in occurrence. However, it can be associated with high morbidity and mortality. As such, a multi-disciplinary approach to care is integral to ensuring good outcomes in these patients.
椎动脉损伤（VAI）可由颈椎创伤引起。VAI 可能是一种严重的并发症，并有可能损害大脑后部的血管供应。目前，关于这些患者的发病率、治疗和结局的证据很少。本研究的目的是调查和阐明在一家国家三级脊柱病理转诊中心，与颈椎创伤相关的 VAI 的发病率、它们各自的治疗方法和相关结局。
对 2012 年至 2021 年期间因颈椎创伤而发生 VAI 的患者进行回顾性研究。收集人口统计学、临床和影像学数据，以确定损伤特征和治疗方法的共同特征。
在 10 年期间，有 1013 例脊柱患者到我院就诊。739/1013（72.9%）为创伤患者。42/739（5.7%）因疑似创伤引起的 VAI 而接受影像学检查。14/739（1.9%）确诊为 VAI。所有患者均行 CT 血管造影以明确诊断。14 例确诊 VAI 患者中，有 4 例（28.6%）行额外的磁共振血管造影检查。VAI 损伤最常见于右侧（7/14；50%），其次为左侧（5/14；35.7%）和双侧（2/14；14.3%）损伤。8/14（57.1%）患者接受抗血栓治疗。3 个月内急性死亡率为 2/14（14.3%），分别发生在 49 天和 57 天。
与颈椎损伤相关的 VAI 发病率较低，但可导致高发病率和死亡率。因此，多学科治疗方法对于确保这些患者的良好结局至关重要。
