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Presentation and outcome of traumatic spinal fractures

Ahmed El-Faramawy, Ayman El-Menyar, Ahmad Zarour, Kimball Maull, Jane Riebe, Krishna Kumar, John Mathew, Ashok Parchani, Hassan Al-Thani, Rifat Latifi
Journal of Emergencies, Trauma, and Shock 2012, 5 (4): 316-20

BACKGROUND: Motor vehicle crashes and falls account for most of the spine fractures with subsequent serious disability.

AIM: To define the incidence, causes, and outcome of spinal fractures.

MATERIALS AND METHODS: Data were collected retrospectively from trauma registry database of all traumatic spinal injuries admitted to the section of trauma surgery in Qatar from November 2007 to December 2009.

RESULTS: Among 3712 patients who were admitted to the section of trauma surgery, 442 (12%) injured patients had spinal fractures with a mean age of 33.2 ± 12 years. The male to female ratio was 11.6:1. Motor vehicle crashes (36.5%) and falls from height (19.3%) were the leading causes of cervical injury (P = 0.001). The injury severity score ranged between 4 and 75. Nineteen percent of cases with cervical injury had thoracic injury as well (P = 0.04). Lumber injury was associated with thoracic injury in 27% of cases (P < 0.001). Combined thoracic and lumber injuries were associated with cervical injury in 33% of cases (P < 0.001). The total percent of injuries associated with neurological deficit was 5.4%. Fifty-three cases were managed surgically for spine fractures; 14 of them had associated neurological deficits. Overall mortalityrate was 5%.

CONCLUSIONS: Spine fractures are not uncommon in Qatar. Cervical and thoracic spine injuries carry the highest incidence of associated neurological deficit and injuries at other spinal levels. Young males are the most exposed population that deserves more emphasis on injury prevention programs in the working sites and in enforcement of traffic laws.

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