TY  - JOUR
PY  - 2018//
TI  - Traumatic fractures of the cervical spine: analysis of changes in incidence, etiology, concurrent injuries and complications among 488,262 patients from 2005-2013
JO  - World neurosurgery
A1  - Passias, Peter G.
A1  - Poorman, Gregory W.
A1  - Segreto, Frank A.
A1  - Jalai, Cyrus M.
A1  - Horn, Samantha R.
A1  - Bortz, Cole A.
A1  - Vasquez-Montes, Dennis
A1  - Diebo, Bassel G.
A1  - Vira, Shaleen
A1  - Bono, Olivia J.
A1  - De La Garza-Ramos, Rafael
A1  - Moon, John Y.
A1  - Wang, Charles
A1  - Hirsch, Brandon P.
A1  - Zhou, Peter L.
A1  - Gerling, Michael
A1  - Koller, Heiko
A1  - Lafage, Virginie
SP  - e427
EP  - e437
VL  - 110
IS  - 
N2  - OBJECTIVE: The etiologies and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, etiology, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. <br><br>METHODS: Retrospective review of the Nationwide Inpatient Sample. ICD-9 E-Codes identified trauma cases from 2005-2013. Patients with cervical fracture were isolated. Demographics, incidence, etiology, fracture levels, concurrent injuries, surgical procedures, and complications were analyzed. T-tests elucidated significance for continuous variables, chi-square for categorical variables. Level of significance P<0.05. <br><br>RESULTS: 488,262 patients isolated (age:55.96, male:60.0%, white:77.5%). Incidence (2005:4.1% vs 2013:5.4%), Charlson-Comorbidity-Index (2005:0.6150 vs. 2013:1.1178), and total charges (2005:$71,228.60 vs. 2013:$108,119.29) have increased since 2005, while length of stay (LOS) decreased (2005:9.22 vs. 2013:7.86) (all P<0.05). Most common etiologies were MVA (29.3%), falls (23.7%) and pedestrian accidents (15.7%). Most frequent fracture types were closed at C2 (32.0%) and C7 (20.9%). Concurrent injury rates have significantly increased since 2005 (2005:62.3% vs. 2013:67.6%). Common concurrent injuries included fractures to the rib/sternum/larynx/trachea (19.6%). Overall fusion rates have increased since 2005 (2005:15.7% vs 2013:18.0%), while decompressions and halo insertion rates have decreased (all P<0.05). SCIs have significantly decreased since 2005, except for upper-cervical central cord syndrome. Complication rates have significantly increased since 2005 (2005:31.6% vs. 2013:36.2%). Common complications included Anemia (7.7%), Mortality (6.6%), and ARDS (6.6%). <br><br>CONCLUSION: Incidence, complications, concurrent injuries, and fusions have increased since 2005. LOS, SCIs, decompressions and halo insertions have decreased. Indicated trends should guide future research in management guidelines.<br><br>Copyright © 2017 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1878-8750
UR  - http://dx.doi.org/10.1016/j.wneu.2017.11.011
ID  - ref1
ER  -