Cervical spine injuries requiring surgery in a Level I trauma centre in a major German city

Roslind Karolina Hackenberg,Jasmin Scorzin,Kristian Welle,Koroush Kabir,Charlotte Rommelspacher,Martin Gathen,Paul Stoll

doi:10.1007/s00701-021-05029-1

Roslind Karolina Hackenberg, Jasmin Scorzin + Show 5 more

Open Access

https://doi.org/10.1007/s00701-021-05029-1

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Abstract

BackgroundCervical spine injuries (CSI) are rare in trauma patients, at about 9.2–16.5/100,000 inhabitants in Scandinavia and Canada, and the annual incidence of CSI surgeries in Norway is around 3.0/100,000 inhabitants. However, despite their rarity, the incidence of CSI has increased, thereby assuming an increasing need for surgery. Outside of Scandinavia, no data about the incidence of CSI and subsequent surgeries exist. Therefore, this study aimed to analyse CSI epidemiology and surgery in a German city with a Level I trauma centre both to understand the injury and improve needs–based planning.MethodsThis retrospective, monocentre study included all patients who presented with CSI from 2012–2017 at a university hospital with a Level I trauma centre in a major German city and had permanent residency within the city. Based on the assumption that the patients represented all CSI injuries in the city, as they were treated at the only available Level I trauma centre, the annual incidence of surgeries and neurologic deficits due to CSI were calculated.ResultsA total of 465 patients with 609 CSI were identified. Of these patients, 61 both received surgery and resided in the city (mean age, 68.1 ± 18.3 years; 26 female, 35 male). The incidence of CSI surgeries was calculated as 3.24/100,000 person years (1.75/100,000 in the upper and 1.54/100,000 in the subaxial cervical spine). Neurologic deficits occurred in 0.64/100,000 person years. The incidence of both surgeries and neurologic deficits showed no significant changes over the 6-year study period.ConclusionsCompared to Scandinavia, an increasing annual incidence for CSI surgeries and neurologic deficits were found. For long-term demand planning with adaptability to demographic changes, cross-regional studies including long-term follow-up are necessary.

Highlights

Cervical spine injuries (CSI) are a rare entity among trauma and polytrauma patients [4]
Of the 130 patients with a mean age of 67.5 ± 20.4 years, 61 received surgery (46.9%), while 58 received conservative treatment (44.6%) with a cervical collar for an average of 6 weeks, and 11 did not need a specific treatment (8.5%), because their injury had no risk for instability or non-union
The incidence of CSI surgeries was calculated by means of the 61 patients who received surgical treatment

Summary

Introduction

Cervical spine injuries (CSI) are a rare entity among trauma and polytrauma patients [4]. Cervical spine injuries (CSI) are rare in trauma patients, at about 9.2–16.5/100,000 inhabitants in Scandinavia and Canada, and the annual incidence of CSI surgeries in Norway is around 3.0/100,000 inhabitants. Despite their rarity, the incidence of CSI has increased, thereby assuming an increasing need for surgery. This study aimed to analyse CSI epidemiology and surgery in a German city with a Level I trauma centre both to understand the injury and improve needs–based planning. Based on the assumption that the patients represented all CSI injuries in the city, as they were treated at the only available Level I trauma centre, the annual incidence of surgeries and neurologic deficits due to CSI were calculated. For long-term demand planning with adaptability to demographic changes, cross-regional studies including long-term follow-up are necessary

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