Wednesday, September 26, 2018 10:35 AM – 12:00 PM Cervical Spine Trauma: 23. An epidemiological study of 131,176 fractures of the cervical and thoracic spine from 2007 to 2016 in the United States

Abstract

BACKGROUND CONTEXT Fractures of the spine cause significant disturbances in patient lives and functioning, yet the causes and epidemiological trends of both cervical and thoracic spine fractures have not been well delineated with sufficiently powered studies. PURPOSE This study sought to investigate the epidemiology of cervical and thoracic spine fractures over a 10-year period in the United States. Specifically, we evaluated these fractures by location, levels injured, and mechanism of injury and identified temporal trends in patient demographics and disposition in the United States. STUDY DESIGN/SETTING Retrospective review of prospectively-collected data. PATIENT SAMPLE All patients who visited the emergency department (ED) between January 1, 2007 and December 31, 2016 and were diagnosed with a cervical and/or thoracic spine fracture from the National Electronic Injury Surveillance System (NEISS) database. OUTCOME MEASURES Demographics, mechanism of injury, levels involved, nationwide estimation of frequency and incidence rates by age, sex, and race, and temporal trends. METHODS The National Electronic Injury Surveillance System (NEISS) database was used to identify all patients who visited the emergency department (ED) between January 1, 2007 and December 31, 2016 and were diagnosed with a cervical and/or thoracic spine fracture. The data were stratified by demographic variables and mechanism of injury. The nationwide estimation of frequency and incidence rates by age, sex, and race were determined using NEISS weight calculations and 2007-2016 US census data. Temporal trends of injuries were analyzed using descriptive statistics and linear regression. RESULTS An estimated total of 131,176 fractures were identified, with approximately 95.4% involving the thoracic region, 4.7% involving the cervical region, and 1.2% involving both. Of the total cases, 91.1% were reported as single-level fractures, while 8.86% were reported as multilevel fractures. The annual estimated number of these type of fractures increased from 10,020 in 2007 to 18,168 in 2016 (beta=0.89, p CONCLUSIONS During the last decade, the incidence of fractures of the cervical and thoracic spine increased significantly. The most common mechanism of injury was due to falls. The majority of these injury fractures occurred between ages 80 and 89 and occurred more often in females. The incidence rate of these fractures was highest among whites, compared to blacks and other. Hospital admissions for these fractures were observed to have increased over the time period, though this was not statistically significant. Understanding these patterns can help improve recognition of cervical and thoracic spine fractures. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.