Epidemiology of Traumatic Cervical Spinal Fractures and Risk Factors for Traumatic Cervical Spinal Cord Injury in China

Abstract

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.