Earthquake-related versus non-earthquake-related injuries in spinal injury patients: differentiation with multidetector computed tomography

Abstract

IntroductionIn recent years, several massive earthquakes have occurred across the globe. Multidetector computed tomography (MDCT) is reliable in detecting spinal injuries. The purpose of this study was to compare the features of spinal injuries resulting from the Sichuan earthquake with those of non-earthquake-related spinal trauma using MDCT.MethodsFeatures of spinal injuries of 223 Sichuan earthquake-exposed patients and 223 non-earthquake-related spinal injury patients were retrospectively compared using MDCT. The date of non-earthquake-related spinal injury patients was collected from 1 May 2009 to 22 July 2009 to avoid the confounding effects of seasonal activity and clothing. We focused on anatomic sites, injury types and neurologic deficits related to spinal injuries. Major injuries were classified according to the grid 3-3-3 scheme of the Magerl (AO) classification system.ResultsA total of 185 patients (82.96%) in the earthquake-exposed cohort experienced crush injuries. In the earthquake and control groups, 65 and 92 patients, respectively, had neurologic deficits. The anatomic distribution of these two cohorts was significantly different (P < 0.001). Cervical spinal injuries were more common in the control group (risk ratio (RR) = 2.12, P < 0.001), whereas lumbar spinal injuries were more common in the earthquake-related spinal injuries group (277 of 501 injured vertebrae; 55.29%). The major types of injuries were significantly different between these cohorts (P = 0.002). Magerl AO type A lesions composed most of the lesions seen in both of these cohorts. Type B lesions were more frequently seen in earthquake-related spinal injuries (RR = 1.27), while we observed type C lesions more frequently in subjects with non-earthquake-related spinal injuries (RR = 1.98, P = 0.0029).ConclusionsSpinal injuries sustained in the Sichuan earthquake were located mainly in the lumbar spine, with a peak prevalence of type A lesions and a high occurrence of neurologic deficits. The anatomic distribution and type of spinal injuries that varied between earthquake-related and non-earthquake-related spinal injury groups were perhaps due to the different mechanism of injury.

Spinal Injuries in the 2012 Twin Earthquakes, Northwest Iran

“…This finding is similar to that of the studies on the neurosurgical complications during the previous earthquakes 310 11 12 In studies performed after the Sichuan, China earthquake in 2008, 40-55% of the patients with spinal injuries were reported to suffer from lumbar involvement 1011 12 Interestingly, in a similar report after Yushu, China earthquake in 2010, Li and colleagues detected lumbar fracture in almost 70% of the patients with spinal fractures 3.…”

“…11 12 In addition, none of our cases with cervical injuries were associated with neurological deficit which is sharply in contrast to the related literature 10. In the present study, three patients with nerve injuries had fractures at different vertebrae including thoracic, lumbar, and sacrum.…”

Biomarkers of sepsis

“…Microparticles may mediate both systemic inflammation and DIC in sepsis. Because the endothelium may be a primary target of circulating microparticles, they may also play a role in the significant and widespread increased vascular permeability that contributes to septic shock123.…”

Yıkıcı Deprem Sonrasında Erken Rehabilitatif Müdahaleler İle Sakatlık Önlenebilir: Kahramanmaraş-Pazarcık Depremi Sonrası Rehabilitasyon Çalışanlarına Mektup

“…Gerek deprem öncesi gerek deprem sonrası oluşan bu yaralanmalara sahip hastalarda ağrı yönetimi başta olmak üzere nörolojik defisit oluşma ihtimalini minimize etmek için uygun terapatik müdahaleler sağlanmalıdır. 8 Hasta nakilleri yapılarak ya da gerekli ekipman desteği verilerek rehabilitasyon hizmetleri sürdürülmelidir.…”