Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study

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	Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study
	Wang HW(王洪伟); Ou L(欧兰); Zhou Y(周跃); Li ZQ(李长青); Liu J(刘军); Chen Y(陈语); Yu HL(于海龙); Wang Q(王琪); Zhao YW(赵忆文); Han JD(韩建达)
刊名	MEDICINE
	2016
卷号	95 期号:43 页码:1-7
关键词	cervical epidemiology fracture neurological deficits spine
ISSN号	0025-7974
通讯作者	王洪伟 ; 刘军
产权排序	4
中文摘要	To investigate the incidence and pattern of patients managed for traumatic upper cervical spinal fractures (TUCSFs) in teaching hospitals in China over 13 years.We retrospectively reviewed 351 patients with TUCSF admitted to our teaching hospitals. Incidence rates were calculated with respect to age, gender, etiologies of trauma, anatomical distribution, anatomical classification, American spinal injury association impairment scale (ASIA) classification of neurological deficit and associated injuries.There were 260 male and 91 female patients, with a mean age of 44.216.3 years. The mean age of the patients significantly increased by year of admission, from 35.2 +/- 14.5 years to 47.5 +/- 17.2 years (P = 0.005). Motor vehicle accidents (MVAs) (n = 132, 37.6%) and high falls (n = 104, 29.6%) were the 2 most common mechanisms. The number of C2 fractures (n = 300, 85.5%) was significantly higher than that of C1 (n = 99, 28.2%) (P<0.001). High falls resulted in significantly more Type I C1 fractures than other etiologies (all P<0.001). MVAs resulted in many more Type II and Type III C1 fractures and Type II and Type III C2 fractures than other etiologies. High falls were the most common injury type (n = 44, 36.4%) resulting in neurological deficits. Patients who presented with Landell classification Type I single C1 fracture (n = 6, 42.9%) had the highest rate of neurological deficits. Eighty-two patients had combined injuries; the most common pattern was cervical+cervical spine (n = 44, 12.5%), followed by cervical+thoracic spine (n = 27, 7.7%). A total of 121 patients (34.5%) suffered neurological deficits. Of all patients with TUCSF without combined injuries, single C2 fractures accounted for the highest rate of neurological deficits (n = 62, 32.0%). Multivariate logistic regression analysis indicated that sex (OR = 1.876, 95% CI: 1.022-3.443, P = 0.042), etiology (MVA pedestrians vs high fall: OR = 0.187, 95% CI: 0.056-0.629, P = 0.007), level (C1+OFs vs C1: OR = 6.264, 95% CI: 1.152-34.045, P = 0.034), and injury severity scoring (ISS) (OR = 1.186, 95% CI: 1.133-1.242, P<0.001) were independent risk factors of neurological deficit.The most common causes of TUCSF were MVAs and high falls; single C2 fractures without combined injuries accounted for the most common neurological deficits. Different etiologies resulted in different specific anatomical injuries and neurological deficits. We should make early diagnoses and initiate timely treatment according to different TUCSF patterns.
WOS标题词	Science & Technology ; Life Sciences & Biomedicine
类目[WOS]	Medicine, General & Internal
研究领域[WOS]	General & Internal Medicine
关键词[WOS]	CORD-INJURY ; CLINICAL ARTICLE ; SCREW FIXATION ; RISK-FACTORS ; EPIDEMIOLOGY ; COHORT ; INSTRUMENTATION ; DISLOCATION ; PREDICTORS ; EXPERIENCE
收录类别	SCI
语种	英语
WOS记录号	WOS:000387272700025
内容类型	期刊论文
源URL	[http://ir.sia.cn/handle/173321/19430]
专题	沈阳自动化研究所_机器人学研究室
推荐引用方式 GB/T 7714	Wang HW,Ou L,Zhou Y,et al. Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study[J]. MEDICINE,2016,95(43):1-7.
APA	Wang HW.,Ou L.,Zhou Y.,Li ZQ.,Liu J.,...&Xiang LB.(2016).Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study.MEDICINE,95(43),1-7.
MLA	Wang HW,et al."Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study".MEDICINE 95.43(2016):1-7.