Abstract
AimThe aim of this study was to estimate the incidence of traumatic cervical spine fractures (CS-fx) in a general population.BackgroundThe incidence of CS-fx in the general population is largely unknown.MethodsAll CS-fx (C0/C1 to C7/Th1) patients diagnosed with cervical-CT in Southeast Norway (2.7 million inhabitants) during the time period from April 27, 2010-April 26, 2011 were prospectively registered in this observational cohort study.ResultsOver a one-year period, 319 patients with CS-fx at one or more levels were registered, constituting an estimated incidence of 11.8/100,000/year. The median age of the patients was 56 years (range 4–101 years), and 68% were males. The relative incidence of CS-fx increased significantly with age. The trauma mechanisms were falls in 60%, motorized vehicle accidents in 21%, bicycling in 8%, diving in 4% and others in 7% of patients. Neurological status was normal in 79%, 5% had a radiculopathy, 8% had an incomplete spinal cord injury (SCI), 2% had a complete SCI, and neurological function could not be determined in 6%. The mortality rates after 1 and 3 months were 7 and 9%, respectively. Among 319 patients, 26.6% were treated with open surgery, 68.7% were treated with external immobilization with a stiff collar and 4.7% were considered stable and not in need of any specific treatment. The estimated incidence of surgically treated CS-fx in our population was 3.1/100,000/year.ConclusionsThis study estimates the incidence of traumatic CS-fx in a general Norwegian population to be 11.8/100,000/year. A male predominance was observed and the incidence increased with increasing age. Falls were the most common trauma mechanism, and SCI was observed in 10%. The 1- and 3-month mortality rates were 7 and 9%, respectively. The incidence of open surgery for the fixation of CS-fx in this population was 3.1/100,000/year.Level of evidenceThis is a prospective observational cohort study and level II-2 according to US Preventive Services Task Force.
Highlights
The incidence of CS-fx in the general population is largely unknown
The trauma mechanisms were falls in 60%, motorized vehicle accidents in 21%, bicycling in 8%, diving in 4% and others in 7% of patients
This study estimates the incidence of traumatic CS-fx in a general Norwegian population to be 11.8/ 100,000/year
Summary
The incidence of traumatic cervical spine fractures (CS-fx) in the general population is largely unknown. Several reports describe the incidence of CS-fx in different subpopulations, such as trauma center patients, specific age groups, head injury patients, military populations and osteoporotic patients [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15]. The relationships described between CS-fx and gender, age, trauma mechanism, head injury and SCI are based on studies of subpopulations of trauma patients and not on trauma cases from a general population. These “well-accepted” relationships may not be true for cervical spine injuries in a general population
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More From: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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