The combat burst fracture study—results of a cohort analysis of the most prevalent combat specific mechanism of major thoracolumbar spinal injury

Freedman, Brett A.; Serrano, Jose A.; Belmont, Philip J.; Jackson, Keith L.; Cameron, Brian; Neal, Chris J.; Wells, Rosemary; Yeoman, Chevas; Schoenfeld, Andrew J.

doi:10.1007/s00402-014-2066-9

Cited by 15 publications

(12 citation statements)

References 17 publications

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“…IEDs have a characteristic injury pattern in that they are typically localized to the thoracic and lumbar spine and classically burst fractures. 9 In the Iraq War, it was estimated that IEDs produced approximately 75%-80% of all military personnel combat casualties. 10 In Iraq, thoracolumbar injury classification and severity score was substantially higher in combat burst fractures than all other mechanisms of injury.…”

Section: Discussionmentioning

confidence: 99%

Devastating neurologic injuries in the Syrian war

et al. 2019

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BackgroundSince 2011, hundreds of thousands of Syrians have been displaced and injured due to the ongoing Syrian civil war. In this study, we report the prevalence of neurologic injuries in a major rehabilitation center on the Turkish–Syrian border where death and injury tolls continue to rise.MethodBased on several on-site visits from 2013 to 2016, medical practitioners collected data from patients in the major rehabilitation center on the border of Turkey and Syria. The clinical data, which included the type and cause of injury, laterality, paralysis, areas injured, and treatment offered, were analyzed.ResultsA total of 230 patients were identified as having sustained a neurologic injury, 221/230 (96.1%) male and 9/230 (3.91%) female, ranging from ages 2–52 years. A total of 305 total injuries were documented over the course of a 4-year analysis due to several patients having multiple injuries. Gunshot wounds were the dominant mechanism of injury in 125/230 (54.3%) patients. Patients more frequently sustained single injuries 152/230 (66.1%) than multiple injuries 78/230 (33.9%). Peripheral nerve injuries were the most prevalent injuries, at 92.5% of all neurologic injuries (282/305), specifically injury to the radial nerve, at 19.1% (54/282) of peripheral injuries. Patients with spinal cord injuries made up 20/230 (8.7%) of all patients, with thoracic spine injuries composing 50% (10/20). Traumatic brain injuries were the least prevalent, 3/230 (1.3%), with an equal distribution of subtypes.ConclusionThis study and critical analysis of the devastation in Syria suggests the desperate need for emergency aid.

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Section: Discussionmentioning

confidence: 99%

Devastating neurologic injuries in the Syrian war

et al. 2019

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“…7 , 11 Freedman et al 11 described the "combat burst fracture" as one of the most frequent major spinal injuries, associated with an increasing incidence of neurological injury and poor outcomes. 11 In particular, low lumbar burst fractures ( i.e. , burst fractures of L3-L5) are rare injuries with unclear operative indications, and in some patients, the surgical course of these injuries is laden with complications.…”

Section: Discussionmentioning

confidence: 99%

“…11 Therefore, the purpose of the present study is to report the clinical outcomes of all service members…”

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confidence: 99%

Outcomes After Operative Management of Combat-Related Low Lumbar Burst Fractures

Formby

Wagner

Pisano

et al. 2015

Spine

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“…3) Seventy-six percent of the injuries were multilevel noncontiguous spinal fractures, and the usual incidence of these injuries is only 10–15% [8]. 4) The mechanisms of blast injuries lead to an increased incidence of burst fractures of the lower lumbar vertebra and lumbosacral separation, which required higher levels of wartime medical care [9–11]. 5) The incidence of penetrating spinal injuries is much higher than usual, and the ratio of these injuries requiring surgical interventions in field hospitals was higher than that of closed injuries [12].…”

Section: Overviewmentioning

confidence: 99%

Chinese expert consensus on the treatment of modern combat-related spinal injuries

et al. 2019

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The battlefield treatments of spinal and spinal cord injury vary from civilian settings. However, there is no unified battlefield treatment guidelines for spine trauma in PLA. An expert consensus is reached, based on spine trauma epidemiology and the concepts of battlefield treatment combined with the existing levels of military medical care in modern warfare. Since the specialized treatment for spine trauma are no significant difference between civilian settings and modern war, the first aid, emergency treatment and early treatment of spine trauma are introduced separately in three levels in this consensus. In Level I facilities, the fast and accurate evaluation of spine trauma followed by fixation and stabilization are recommended during the first-aid stage. Re-evaluation, further treatment for possible hemorrhagic shock, dyspnea and infection are recommended at Level II facilities. At Level III facilities, it is recommended to strengthen the intensive care and the prevention of urinary system and lung infection for the wounded with severe spinal injury, however, spinal surgery is not recommended in a battlefield hospital. The grading standard for evidence evaluation and recommendation was used to reach this expert consensus.

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The combat burst fracture study—results of a cohort analysis of the most prevalent combat specific mechanism of major thoracolumbar spinal injury

Cited by 15 publications

References 17 publications

Devastating neurologic injuries in the Syrian war

Devastating neurologic injuries in the Syrian war

Outcomes After Operative Management of Combat-Related Low Lumbar Burst Fractures

Chinese expert consensus on the treatment of modern combat-related spinal injuries

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