Citation

Blair JA, Patzkowski JC, Schoenfeld AJ, Cross Rivera JD, Grenier ES, Lehman RA, Hsu JR. J. Bone Joint Surg. Am. 2012; 94(18): e1351-9.

Affiliation

Skeletal Trauma Research Consortium (STReC) Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center (J.A.B., J.C.P., J.D.C.R., and E.S.G.), and the United States Army Institute of Surgical Research (J.C.P., J.R.H., and STReC), 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234. E-mail address for J.A. Blair: james.blair@amedd.army.mil. E-mail address for J.C. Patzkowski: jeanne.patzkowski@amedd.army.mil. E-mail address for J.D. Cross Rivera: jessica.rivera@amedd.army.mil. E-mail address for E.S. Grenier: eric.grenier@amedd.army.mil. E-mail address for J.R. Hsu and STReC: joseph.hsu@amedd.army.mil.

Copyright

(Copyright © 2012, Journal of Bone and Joint Surgery)

DOI

10.2106/JBJS.K.00502

PMID

22992883

Abstract

BACKGROUND: While combat spinal injuries have been documented since the fourth century BC, a comprehensive analysis of such injuries has not been performed for any American military conflict. Recent literature has suggested that spinal injuries account for substantial disability in wounded service members. METHODS: The Joint Theater Trauma Registry was queried to identify all American military personnel who sustained injuries to the back, spinal column, and/or spinal cord in Iraq or Afghanistan from October 2001 to December 2009. Spinal injuries were categorized according to anatomic location, neurological involvement, mechanism of injury, and concomitant wounds. RESULTS: Of 10,979 evacuated combat casualties, 598 (5.45%) sustained 2101 spinal injuries. Explosions accounted for 56% of spinal injuries, motor vehicle collisions for 29%, and gunshots for 15%. Ninety-two percent of all injuries were fractures, with transverse process, compression, and burst fractures the most common. Spinal cord injuries were present in 17% (104) of the 598 patients. Concomitant injuries frequently occurred in the abdomen, chest, head, and face. CONCLUSIONS: The incidence of spine trauma sustained by military personnel in Iraq and Afghanistan is higher than that reported for previous conflicts, and the nature of these injuries may be similar to those in severely injured civilians. Further research into optimal management and rehabilitation is critical for military service members and severely injured civilians with spine trauma.

Language: en