Spiral Computed Tomography for the Diagnosis of Cervical, Thoracic, and Lumbar Spine Fractures: Its Time has Come

Brown, Carlos; Antevil, Jared L.; Sise, Michael J.; Sack, Daniel I.

doi:10.1097/01.ta.0000162149.89139.ff

Cited by 110 publications

(56 citation statements)

References 13 publications

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“…Brown et al [4] reported that a spiral CT scan was suitable to completely replace plain radiographs for thoracolumbar screening. Griffey et al [8] subsequently reported that CT scan thoracolumbar reformats had completely replaced plain films for screening at their Level 1 Trauma Center.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Has the Incidence of Thoracolumbar Spine Injuries Increased in the United States From 1998 to 2011?

Doud

Weaver

Talton

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background While most motor vehicle crash (MVC)-related injuries have been decreasing, one study showed increases in MVC-related spinal fractures from 1994 to 2002 in Wisconsin. To our knowledge, no studies evaluating nationwide trends of MVC-related thoracolumbar spine injuries have been published. Such fractures can cause pain, loss of functionality or even death. If the incidence of such injuries is increasing, it may provide a motive for reassessment of current vehicle safety design. Questions/purposes We questioned whether the incidence of thoracolumbar spine injuries increased in the United States population with time (between 1998 and 2011), and if there was an increased incidence of thoracolumbar injuries, whether there were identifiable compensatory ''trade-off injury'' patterns, such as reductions in sacropelvic injuries. [1998][1999][2000][2001][2002][2003][2004][2005][2006][2007]. In each database, the total number of MVCrelated injuries and the number of MVC-related thoracolumbar injuries per year were identified using appropriate Abbreviated Injury Scale (AIS) or ICD-9 codes. Sacropelvic injuries also were identified to evaluate their potential as trade-off injuries. Poisson regression models adjusting for age were used to analyze trends in the data with time.Results All databases showed increases in MVC-related thoracolumbar spine injuries when adjusting for age with time. These age-adjusted relative annual percent increases ranged from 8.22% (95% CI, 5.77%-10.72%; p \ 0.001) using AIS of 2 or more (AIS2 +) injury codes in the NTDB 1 , 8.59% (95% CI, 5.88%-11.37%; p \ 0.001) using ICD-9 codes in the NTDB 1 , 8.12% (95% CI, 7.20%-9.06%; p \ 0.001) using ICD-9 codes in the NIS, and 8.10 % (95% CI 5.00%-11.28%; p \ 0.001) using AIS2+ injury codes in the NASS. As these thoracolumbar injuries have increased, there has been no consistent trend toward a compensatory reduction in terms of sacropelvic injuries.Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was not required. 123Clin Orthop Relat Res (2015) 473:297-304 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons®Conclusions While other studies have shown that rates of many MVC-related injuries are declining with time, our data show increases in the incidence of thoracolumbar injury. Although more sensitive ...

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Section: Discussionmentioning

confidence: 99%

“…For example, as more individuals survive MVCs, lower extremity injuries have become more significant [7]. Conversely, more sensitive imaging, especially for the thoracic and lumbar spine, may account for increasing recognition of thoracolumbar injuries in MVC survivors [4,8].…”

Section: Introductionmentioning

confidence: 99%

Has the Incidence of Thoracolumbar Spine Injuries Increased in the United States From 1998 to 2011?

Doud

Weaver

Talton

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…To that end, therapeutic algorithms need to address the outermost importance of SI in MI-patients including a standardized diagnostic work-up of the spine. The exact diagnostic procedures to achieve this result remain a matter of discussion -CT-scanning is available in most traumacenters and meanwhile considered the golden standard [26] due to lower cost [27], diagnostic accuracy [22,[28][29][30][31] and speed [32], however, others still employ plain radiographs [33] especially for screening the axial skeleton before performing CT-scans of a suspicious region [34].…”

Section: Discussionmentioning

confidence: 99%

Distribution of Spinal and Associated Injuries in Multiple Trauma Patients

Laurer

Maier²,

Saman³

et al. 2007

Eur J Trauma Emerg Surg

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Injury to the spinal column and cord are often part of life-threatening multiple trauma. Epidemiological data could help to establish an evidence-based assessment and therapy of these patients. We present a retrospective chart analysis of 590 multiple traumatized patients admitted within a 4-year-period. Patients suffering from injuries of the spinal column were analysed regarding mechanism and distribution of their injuries to all body regions. Thirty-one percent (n = 183) of polytraumatized patients displayed a spine injury. Distribution analysis showed peaks in the cervical spine and the thoraco-lumbar junction. The risk of relevant associated injuries is mainly influenced from anatomical vicinity to the injured spinal segment. Injuries to the spinal column are frequent in the multiple trauma patients population. Diagnosed injuries to distinct body regions should make the trauma team suspicious of injury to the nearby spinal column. Appropriate treatment includes thorough assessment of all injuries to clarify the damage and carry on special protection of these spinal regions preventing from deterioration.

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“…It is possible to show fractures missed by plain films. 9,10 On the other hand, MSCT has some disadvantages including high cost, requirement of considerable time for evaluation, and the risks of radiation. Moreover, there are some unclear points concerning the appropriate patient groups (lack of evidencebased information etc.)…”

Section: E7mentioning

confidence: 99%

Retrospective Analysis of Whole-Body Multislice Computed Tomography Findings Taken in Trauma Patients

Köse¹

2015

Tr J Emerg Med

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a b s t r a c tObjectives: Using whole-body multislice computed tomography (MSCT) excessively or with irrelevant indications can be seen in many centers. The aim of this study was to analyze retrospectively the MSCT findings in trauma patients admitted to the emergency department. Methods: Records of the patients who have applied to the emergency department due to blunt trauma in a 12 month period and whose whole body MSCT images have been taken, were evaluated using the "Nucleus Medical Information System". Results: The most frequent type of trauma was traffic accidents in 61.4%, falling down from the height in 22.4%, and motorcycle accidents in 11.4% of patients. Of the patients, 25.2% were discharged from the emergency, while 73.8% were hospitalized. At least one CT findings associated with trauma was present in 61.4% of our patients. Pathological findings in MSCT were most frequently detected in the head and face (35.3%) and thoracic (28.6%) regions, respectively. The most common finding in the head and face region was fractures. The most common pathological findings in the thoracic region were pulmonary contusion and rib fractures. A significant relationship was detected between trauma type and spinal MSCT result (p < 0.001). In a large percentage of the patients, MSCT findings were normal in the abdominal region and genitourinary system. Vertebral fractures were most frequently detected in the thoracolumbar region. Conclusions: In our study, our rate of negative CT was found to be 38.6%, which is a higher ratio compared to other studies conducte on this topic.

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Spiral Computed Tomography for the Diagnosis of Cervical, Thoracic, and Lumbar Spine Fractures: Its Time has Come

Cited by 110 publications

References 13 publications

Has the Incidence of Thoracolumbar Spine Injuries Increased in the United States From 1998 to 2011?

Has the Incidence of Thoracolumbar Spine Injuries Increased in the United States From 1998 to 2011?

Distribution of Spinal and Associated Injuries in Multiple Trauma Patients

Retrospective Analysis of Whole-Body Multislice Computed Tomography Findings Taken in Trauma Patients

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