Incidence and Demographics of Cervical Spine Fractures over a 10 Year Period at a Level I Trauma Center

Abstract

ABSTRACT Background In an effort to capture all cervical fractures in the trauma setting, many institutions have implemented protocols for urgent cervical computed tomographic (CT) imaging for any patient with traumatic neck pain. This has led to a high frequency of negative imaging studies. Objectives The objective is to characterize a consecutive series of cervical spine fractures diagnosed at a single Level I trauma center over a 10-year period. It is expected that a greater awareness of the associations between age, injury mechanism, and fracture type may facilitate the diagnosis and management of patients with cervical spine trauma. Methods In this study, every cervical CT scan ordered in the Emergency Department (ED) at our institution was reviewed and evaluated for fractures. The relevant demographic data and mechanism of injury for patients with fractures were recorded. Results Of 763,099 ED visits, 13,896 cervical CT scans were ordered (1.8% of visits) and 492 scans (3.5% of scans, 0.06% of visits) were found to have cervical fractures resulting from blunt trauma. There was a bimodal distribution of fractures with respect to age, with peaks at 20 to 24 and >85 years of age. These age ranges were also found to have higher incidence of fracture than would be predicted by population alone. Fractures in younger patients resulted from high-energy trauma and fractures in older patients resulted primarily from falls. Conclusion This elucidation of epidemiology and mechanism of cervical fractures can be used to improve the rapidity of diagnosis and management of these potentially devastating injuries. Blizzard DJ, Miller CP, Blizzard ST, Grauer JN. Incidence and Demographics of Cervical Spine Fractures over a 10 Year Period at a Level I Trauma Center. The Duke Orthop J 2016;6(1):21-25.