Abstract
ABSTRACT Objective: To determine the epidemiology of spine trauma in patients with polytrauma. Methods: The database of the service of polyfractured patients was reviewed from January to December 2015, 334 patients in total. Among them, 56 had spinal injury, of which 38 patients were included in the study. Results: Of the patients with polytraumatism, 16.77% had spinal cord injury. Mechanism of injury: fall 63.16%, traffic accidents 21.05%, running over 10.53%. Injury conditions: occupational 36.84%, at home 23.68%, traffic accident 15.79%, public road 13.16%, motorcycle accident 5.26%, of which 13.16% had consumed alcoholic beverages. Total with neurological injury 23.68%, incomplete lesion 18.42%. Injured vertebral segment: lumbar 76.32%, thoracic 31.58%, and cervical 7.89%. Associated injuries: upper limbs 47.37%, lower limbs 42.11%, pelvis 36.84%, thorax 34.21%, craniofacial 31.58%, abdomen 21.05%. Treatment: instrumentation 71.05%, orthoses 26.32%. Infection rate of 22.22%. Conclusions: The most common mechanism of injury was falls in the working environment, almost one fourth presented neurological damage, the most affected segment was the lumbar associated with injury of the lower limbs in 50%, with one fourth of patients that undergone intervention presenting infection. It is in the workplace, at home and in the transit where preventive measures must be reinforced to reduce the incidence of injuries in working age patients.
Highlights
There is little evidence published about the injurious conditions and injuries associated with spine trauma in polyfractured patients.[1,2,3,4,5] Little is said about patients who suffer from multiple trauma in basic orthopedic and spine surgery books.[6,7,8] Patients with spinal trauma are a group who require special attention for their treatment and rehabilitation because of the costs that they generate in the medical, economic, and social environments
The following inclusion criteria were used for the study: a) patients admitted to the Polyfracture Service during the established time period; b) patients with spine lesions at the cervical, thoracic, or lumbar levels, regardless of the number of vertebrae or segments or the type of fracture as defined by the AO classification (A, B, or C); c) patients with recent vertebral lesions attributable to the same injury mechanism causing lesions in other segments; d) patients whose vertebral lesions were confirmed by computed tomography
The most important injury mechanism in this study was falls, which accounted for the majority of cases in the work environment
Summary
There is little evidence published about the injurious conditions and injuries associated with spine trauma in polyfractured patients.[1,2,3,4,5] Little is said about patients who suffer from multiple trauma in basic orthopedic and spine surgery books.[6,7,8] Patients with spinal trauma are a group who require special attention for their treatment and rehabilitation because of the costs that they generate in the medical, economic, and social environments. In addition to presenting various injuries, it is not uncommon for less serious inadvertent injuries to occur. These patients require a prolonged hospital stay, several surgical procedures, and a long recovery time, which means more consultations, more lost work (in the case or working patients), and greater involvement of relatives as caregivers during recovery. The objective of this study was to identify the most common injury mechanisms associated with polyfractured patients with spine injuries, as well as the type and severity of vertebral injuries and other associated injuries, treatments, and complications, and to assist with suspected associated injuries, as well as to determine prognoses for patients with spinal injuries and polytraumatized patients
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