Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (Dec 2012)

The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway

  • Fredø Hege Linnerud,
  • Rizvi Syed Ali Mujtaba,
  • Lied Bjarne,
  • Rønning Pål,
  • Helseth Eirik

DOI
https://doi.org/10.1186/1757-7241-20-85
Journal volume & issue
Vol. 20, no. 1
p. 85

Abstract

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Abstract Aim The aim of this study was to estimate the incidence of traumatic cervical spine fractures (CS-fx) in a general population. Background The incidence of CS-fx in the general population is largely unknown. Methods All CS-fx (C0/C1 to C7/Th1) patients diagnosed with cervical-CT in Southeast Norway (2.7 million inhabitants) during the time period from April 27, 2010-April 26, 2011 were prospectively registered in this observational cohort study. Results Over a one-year period, 319 patients with CS-fx at one or more levels were registered, constituting an estimated incidence of 11.8/100,000/year. The median age of the patients was 56 years (range 4–101 years), and 68% were males. The relative incidence of CS-fx increased significantly with age. The trauma mechanisms were falls in 60%, motorized vehicle accidents in 21%, bicycling in 8%, diving in 4% and others in 7% of patients. Neurological status was normal in 79%, 5% had a radiculopathy, 8% had an incomplete spinal cord injury (SCI), 2% had a complete SCI, and neurological function could not be determined in 6%. The mortality rates after 1 and 3 months were 7 and 9%, respectively. Among 319 patients, 26.6% were treated with open surgery, 68.7% were treated with external immobilization with a stiff collar and 4.7% were considered stable and not in need of any specific treatment. The estimated incidence of surgically treated CS-fx in our population was 3.1/100,000/year. Conclusions This study estimates the incidence of traumatic CS-fx in a general Norwegian population to be 11.8/100,000/year. A male predominance was observed and the incidence increased with increasing age. Falls were the most common trauma mechanism, and SCI was observed in 10%. The 1- and 3-month mortality rates were 7 and 9%, respectively. The incidence of open surgery for the fixation of CS-fx in this population was 3.1/100,000/year. Level of evidence This is a prospective observational cohort study and level II-2 according to US Preventive Services Task Force.

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