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European Spine Journal

, Volume 20, Issue 12, pp 2174–2180

First Online: 05 June 2011Received: 26 December 2010Revised: 14 April 2011Accepted: 22 May 2011


This is a European cohort study on predictors of spinal injury in adult ≥16 years major trauma patients, using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Predictors for spinal fractures-dislocations or spinal cord injury were determined using univariate and multivariate logistic regression analysis. 250,584 patients were analysed. 24,000 patients 9.6% sustained spinal fractures-dislocations alone and 4,489 1.8% sustained spinal cord injury with or without fractures-dislocations. Spinal injury patients had a median age of 44.5 years IQR = 28.8–64.0 and Injury Severity Score of 9 IQR = 4–17. 64.9% were male. 45% of patients suffered associated injuries to other body regions. Age <45 years ≥45 years OR 0.83–0.94, Glasgow Coma Score GCS 3–8 OR 1.10, 95% CI 1.02–1.19, falls >2 m OR 4.17, 95% CI 3.98–4.37, sports injuries OR 2.79, 95% CI 2.41–3.23 and road traffic collisions RTCs OR 1.91, 95% CI 1.83–2.00 were predictors for spinal fractures-dislocations. Age <45 years ≥45 years OR 0.78–0.90, male gender female OR 0.78, 95% CI 0.72–0.85, GCS <15 OR 1.36–1.93, associated chest injury OR 1.10, 95% CI 1.01–1.20, sports injuries OR 3.98, 95% CI 3.04–5.21, falls >2 m OR 3.60, 95% CI 3.21–4.04, RTCs OR 2.20, 95% CI 1.96–2.46 and shooting OR 1.91, 95% CI 1.21–3.00 were predictors for spinal cord injury. Multilevel injury was found in 10.4% of fractures-dislocations and in 1.3% of cord injury patients. As spinal trauma occurred in >10% of major trauma patients, aggressive evaluation of the spine is warranted, especially, in males, patients <45 years, with a GCS <15, concomitant chest injury and-or dangerous injury mechanisms falls >2 m, sports injuries, RTCs and shooting. Diagnostic imaging of the whole spine and a diligent search for associated injuries are substantial.

KeywordsSpinal cord injury Spinal fractures-dislocations TARN registry Major trauma Predictors Electronic supplementary materialThe online version of this article doi:10.1007-s00586-011-1866-7 contains supplementary material, which is available to authorized users.

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Author: Rebecca M. Hasler - Aristomenis K. Exadaktylos - Omar Bouamra - Lorin M. Benneker - Mike Clancy - Robert Sieber - Heinz 

Source: https://link.springer.com/

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