Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Abstract

This review aims to search the epidemiology and incidence rates of thoracolumbar spine fractures. A systematic review of the literature of the last 10 years gave 586 results with “incidence,” and 387 results with “epidemiology,” of which 39 papers were analyzed. The review results were discussed and voted in 2 consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee. Out of 39 studies, 15 studies have focused on thoracolumbar trauma, remaining 24 studies have looked at all spine trauma. Most were retrospective in nature; few were prospective and multicenter. Some studies have focused on specific injuries. The annual incidence of TL fractures is about 30/100,000 inhabitants including osteoporotic fractures. There is a trend to increase the fractures in elderly population especially in developed countries, while an increase of motor vehicle accidents in developing countries. The mortality rate among male elderly patients is relatively high. The incidence of thoracolumbar spine fractures is increasing because of low-velocity falls in the elderly population. The main reasons are falls and traffic accidents. Learning the regional differences and some special forms of trauma such as extreme sports, war, and gunshot injuries will help the prevention of the thoracolumbar spine fractures.

Surgical management of thoracolumbar junction fractures: An evidence-based algorithm

“…Up-to-date data about TLJ fractures report an increasing incidence of 15,000/year, especially among young patients (median age 30 years old). 6 , 7 , 8 …”

One-Year Clinical Outcomes of Minimal-Invasive Dorsal Percutaneous Fixation of Thoracolumbar Spine Fractures

“…This area has an essential role in spine biomechanics as it represents the transition zone from the rigid thoracic spine, which is less mobile due to its connection to the ribs and sternum, to the more flexible lumbar spine [ 2 ]. The global annual incidence of thoracolumbar spine fractures is about 30/100,000 people when osteoporotic fractures are included [ 3 ]. In the USA, 17,000 new spinal cord injury cases occur each year, and more than 250,000 patients are currently living with permanent deficits [ 4 ].…”

“…In the USA, 17,000 new spinal cord injury cases occur each year, and more than 250,000 patients are currently living with permanent deficits [ 4 ]. There is a trend of increased fracture rates in the elderly population, especially in developed countries, while an increase in motor vehicle accidents as a significant etiological factor can be found in developing countries [ 3 ]. Although thoracolumbar fractures were mainly found in younger ages (15–29 years old) in the last century, the median age is currently 35 [ 5 ].…”

“…In 40% to 80% of the cases, disruptions of the thoracolumbar spine are often a result of high-energy injuries by an axial load, with or without flexion force, affecting the anterior and middle columns of the vertebral body [ 1 ]. The majority are the result of motor vehicle accidents and falls [ 3 ]. Blunt trauma is associated with an incidence of 1.9% thoracic fractures [ 4 ].…”

Assessment of Instability in Thoracolumbar Burst Fractures Using a New Bone Scan Scoring System

“…Spinal injuries most frequently occur in the thoracic and lumbar regions, especially at the thoracolumbar junction. There is an increasing incidence of thoracolumbar injury worldwide, mainly due to increased fractures of the elderly population in developed countries and increased motor vehicle accidents in developing countries [ 1 ]. Of thoracolumbar injuries, 10–20% are classified as burst fractures [ 2 ].…”