Abstract
ABSTRACT Objective: To evaluate the profile of patients with fracture and / or dislocation of the subaxial cervical spine using the new AOSpine classification and to correlate it with the trauma mechanism and the type of neurological deficit. Methods: Analyses were performed of the medical records of patients admitted to a tertiary hospital with fracture and / or subaxial cervical dislocation during the period from 2009 to 2016. For the evaluation of the association between the two categorical variables, the Chi-square test was used with a significance level of p <0.05. Results: A total of 67 medical records were analyzed, in which a higher prevalence of type C fractures (49.3%) was observed. The neurological subclassification N4 (35.8%) was the most prevalent type found, followed by subtype N0 (26.9%). Among the main injury mechanisms found, the most prevalent was the motorcycle accident (29.9%). There was no statistically significant association between the injury mechanism and the AOSpine morphological classification (p> 0.05) or neurological deficit (p> 0.05). Conclusion: Cervical fractures of type C, due to automobile accidents were the most prevalent. It was not possible to determine an association between the degree of neurological involvement and the morphology of the injury. Level of Evidence II; Retrospective study.
Highlights
Injuries to the lower cervical spine (C3 to C7) are significantly serious since they often cause damage to the spinal cord leading to associated neurological deficit
One widely used classification is that proposed by the AO (Arbeitsgemeinschaft für Osteosynthesefragen), which has recently been updated in an attempt to increase the degree of concordance, based on modifiers for trauma mechanisms, involvement of the anterior and/or posterior spine, and degree of neurological injury
Analysis of the medical records was based on extraction of complete epidemiological data, such as age at the time of the traumatic event, sex, trauma mechanism and degree of neurological deficit upon admission to the hospital
Summary
Injuries to the lower cervical spine (C3 to C7) are significantly serious since they often cause damage to the spinal cord leading to associated neurological deficit. One widely used classification is that proposed by the AO (Arbeitsgemeinschaft für Osteosynthesefragen), which has recently been updated in an attempt to increase the degree of concordance, based on modifiers for trauma mechanisms, involvement of the anterior and/or posterior spine, and degree of neurological injury. They were classified into three types (A, B and C), six subtypes and 22 modifiers.[6,7,8] In this study, our hypothesis is that the more complex the modifier of the AOSpine fracture mechanism, the greater the degree of neurological impairment. To the authors’ knowledge, there is no statistical association in the current literature between these two AOSpine classification modifiers
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