Wednesday, September 26, 2018 1:00 PM – 2:00 PM Spinal Trauma: 52. Spine fractures in pediatric population: causes, comorbidities, and complications. A review of the National Trauma Data Bank (NTDB)

Abstract

BACKGROUND CONTEXT Spinal fractures account for only 2% to 3% of pediatric injuries. However, they're associated significant comorbidities and complications. PURPOSE This population-based study seeks to determine associated injuries and use of safety devices in pediatric spinal fractures. STUDY DESIGN/SETTING NTDB study. PATIENT SAMPLE A total of 6,008 pediatric patients. OUTCOME MEASURES Mechanism of injury, associated injuries, length of stay, neurological compromise. METHODS Pediatric spinal fractures were gathered from the National Trauma Data Bank for 2012. Data was found using ICD-9 805.xx or 806.xx, external cause of injury and procedure codes frequency, and median analyses were performed. RESULTS A total of 6,008 unique patients presented with 7,732 fractured vertebrae. A total of 2,179 (28.1%) cervical vertebrae, 2,151 (27.8%) lumbar, 2,052 (26.5%) involved the thoracic vertebrae, and the remainder involved sacro-coccyx. A total of 3,482 were male and 2,523 female; 4.2% of patients had an associated spinal cord injury. The most common associated musculoskeletal injury was femur fracture (6.7%), the most common associated organ injury was a lung contusion (4.6%) and 980 (16.3%) patients had associated skull fractures. A total of 15,285 fractures occurred in this patient population. Of the total vertebrae involved, 2,825 (31.7%) were repaired surgically. A total of 164 (2.7%) patients died from complications. A total of 2,708 (45.1%) patients were injured as an occupant of a motor vehicle accident (MVA); 25.8% were the drivers of the motor vehicle and 965 (35.7%) of these did not have a protective device present at the time of injury. More than half, 52.4%, of MVA patients were female. The median age of patients in MVA was 15 years (13-17). Interestingly, 48.9% of these were 16 or 17 years of age; the legal age of driving. Seventy-five (2.8%) of MVA patients died from complications. CONCLUSIONS MVA are the most frequent cause of spinal fractures in pediatric patients. Based on the numbers in this study, this amounts to 7.4 patients who present to ER daily with spine fractures from MVA. Approximately a third of these fractures occurred in patients without a protective device present. Nearly half of these fractures occur in children 16 or 17 years of age, the age when children become legally allowed to operate a motor vehicle. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.