Introduction The assessment of bone density is of great importance nowadays due to the increasing age of patients. Especially in regard to the surgical stabilization of the spine, the assessment of bone density is important for therapeutic decision making. The aim of this work was to record trabecular bone density values using Hounsfield units of the second cervical vertebra. Material and methods The study is a monocentric retrospective data analysis of 198 patients who received contrast-enhanced polytrauma computed tomography in a period of two years at a maximum care hospital. Hounsfield units were measured in three different regions within the C2: dens, transition area between dens and vertebral body and vertebral body. The measured Hounsfield units were converted into bone density values using a validated formula. Results A total of 198 patients were included. The median bone density varied in different regions of all measured C2 vertebrae: in the dens axis, C2 transition area between dens and vertebral body, and in the vertebral body bone densities were 302.79 mg/cm3, 160.08 mg/cm3, and 240.31 mg/cm3, respectively. The transition area from dens axis to corpus had statistically significant lower bone density values compared to the other regions (p < 0.001). There was a decrease in bone density values after age 50 years in both men and women (p < 0.001). Conclusions The transitional area from dens axis to corpus showed statistically significant lower bone density values compared to the adjacent regions (p < 0.001). This area seems to be a predilection site for fractures of the 2nd cervical vertebra, which is why special attention should be paid here in radiological diagnostics after a trauma.

Introduction The assessment of bone density has gained significance in recent years due to the aging population. Accurate assessment of bone density is crucial when deciding on the appropriate treatment plan for spinal stabilization surgery. The objective of this work was to determine the trabecular bone density values of the subaxial cervical, thoracic and lumbar spine using Hounsfield units. Material and Methods Data from 200 patients who underwent contrast-enhanced polytrauma computed tomography at a maximum care hospital over a two-year period were retrospectively analyzed. HUs were measured with an elliptical measurement field in three different locations within the vertebral body: below the upper plate, in the middle of the vertebral body, and above the base plate. The measured Hounsfield units were converted into bone density values using a validated formula. Results The mean age of the patient collective was 47.05 years. Mean spinal bone density values decreased from cranial to caudal (C3: 231.79 mg/cm³; L5: 155.13 mg/cm³; p < 0.001), with the highest values in the upper cervical spine. Bone density values generally decreased with age in all spinal segments. There was a clear decrease in values after age 50 years (p < 0.001). Conclusions In our study, bone density decreased from cranial to caudal with higher values in the cervical spine. These data from the individual spinal segments may be helpful to comprehensively evaluate the status of the spine and to design a better preoperative plan before instrumentation.

Introduction The severe acute respiratory syndrome-coronavirus-2 (SARS-Cov2) pandemic has been overcome after more than 3 years1. Several patients were affected by neurosurgery-related complications during SARS-CoV-2 infection 2,3. The aim of the present study was to assess the incidence of SARS-Cov2-associated intracranial hemorrhage (ICH), the reasons therefore and to identify predictors of outcome. Methods We retrospectively analyzed data of patients with SARS-CoV-2 infection admitted to the intensive care unit (ICU) of our hospital in the period of 2 years. We included all patients who acquired a SARS-CoV-2 infection and required intensive care treatment. All patients were followed up until death or discharge from ICU. The primary outcome was the incidence of mortality during ICU stay and occurrence of ICH. We compared survivors and non-survivors with ICH during their ICU stay and patients who developed intracerebral hemorrhage with those who did not. Results Four hundred and sixty-seven patients with a mean age of 64.33 (± 14.76) years with confirmed SARS-CoV2-infection were registered. The mortality rate during ICU stay was 32.11%. Within the two years period, 18 out of 467 patients (3,85%) with spontaneous SARS-Cov2-associated ICH were treated in our department. In the multivariate analysis, ICH was not identified as an independent risk factor for mortality. ECMO treatment (OR 5.130, 95%: 1.739-15.133, p=0.003) was the only independent risk factor of the occurrence of ICH. Conclusion SARS-Cov2-associated ICH itself did not result in increased mortality in patients with SARS-CoV-2 infection treated on the ICU. We hypothesize, that increased mortality in patients with ICH is caused by other comorbidities such as renal failure requiring dialysis, age over 65, the use of ECMO and mechanical ventilation. The use of ECMO was found to be the strongest independent risk factor associated with the occurrence of ICH.