مرکز منطقه ای اطلاع رساني علوم و فناوري - Evaluation of vertebral fractures and associated injuries in adults

Latin Abstract :

Objectives: We evaluated vertebra fractures and associat¬ed injuries in adults to determine the profile of patients presenting with a trauma etiology. Methods : The study included 372 patients (264 men, 108 women; mean age 30.4 years; range 18 to 65 years) who were treated for vertebra fractures from 1988 to 2003. Evaluations included demographic features of patients, trau¬ma mechanisms, fracture levels and types, treatment modal¬ities, and associated injuries. The types of fractures were assessed according to the Denis classification. Results : The types of fractures were classified as follows: compression fractures (n=212, 57.0%), burst fractures (n=146, 39.3%), seat belt-induced fractures (n=8, 2.2%), and fracture-dislocations (n=6, 1.6%). Involvement was at one level in 290 patients (77.9%), two levels in 61 patients (16.4%), three levels in 15 patients (4.0%), and four levels in six patients (1.6%). The most common localization was the thoracolumbar spine (transition zone) with 275 fractures (57.2%). The causes of fractures were fall from height in 211 patients (56.7%), traffic accidents in 145 patients (39.0%), and direct trauma in 16 patients (4.3%). Associated fractures were detected in 110 patients (29.6%), the most common being calcaneus fractures in 35 patients (9.4%). Apart from orthopedic problems, 38 patients (10.2%) had other organ injuries and/or head trauma. Treatment was conservative in 302 patients (81.2%) and surgical in 70 patients (18.8%). Conclusion: Every patient presenting after a high-energy trauma should be regarded as having a vertebra fracture until proven otherwise. When a vertebra fracture is detected, investigation should be extended for involve¬ment at other levels and associated injuries.