|
Abstract
|
Introduction: The epidemiology of spinal injuries following serious motor vehicle accidents is not well known. In this study, we describe the mechanisms of injury, patient characteristics and spinal injury distribution and severity. We also aim to describe the associated injuries in these patients.
Methods: Data was extracted from the Co-operative Crash Injury Study (CCIS) database, maintained by Transport Research Laboratory, UK. From June 1998 to January 2006, patients who were prospectively coded as having spinal injuries were identified. Injury severity of single injuries was coded using the Abbreviated Injury Severity (AIS) score, and overall severity was calculated for each occupant using the Injury Severity Score (ISS). We excluded all AIS 1 (minor) injuries from the analysis.
Results: During the study period, 4405 occupants were identified as having sustained a spinal injury. After excluding AIS 1 injuries, there were 457 occupants left. Drivers (63.7%) and young males in the age group 18-34 (26.3%) were the dominant group. The cervical spine (53.2%) was the spinal region most commonly involved and also accounted for most of the severe AIS 5 and 6 spinal injuries. The thoracic spine (30.9%) was the next most involved followed by the lumbar spine (24.7%). There was a high overall mortality (41.6%), and this was most marked amongst the over 65 age group (60%). The majority of occupants had a significant non-spinal AIS =2 injury (89.5%).
Discussion: The cervical spine is the most vulnerable part of the vertebral column during MVCs. Overall mortality, especially in the elderly is high, and prompt identification of associated injuries is important. Further work is needed to study the outcome of patients sustaining spinal injuries as part of major trauma, especially in the elderly. |