Sebastian Schubert (Aachen / DE), Miguel Pishnamaz (Aachen / DE), Mohamad Agha Mahmoud (Aachen / DE), Patrick Krug (Aachen / DE), Frank Hildebrand (Aachen / DE), Christian Herren (Aachen / DE)
Abstract
Background. Cervical spine fractures in multiple-injured patients are rare, but there is a high risk of spinal cord injury. The appropriate timing for the surgical stabilization has not yet been researched. The aim of this study was to analyse the impact of trauma mechanism on fracture localisation and to analyse the impact of surgery timing in respect to the neurological status.
Methods. A retrospective analysis of multiple-injured patients with a trauma of the cervical spine (ISS>16, age>16) was performed from 2012-2016 in two trauma centres. Demographic data, data of the accident, ISS, time to spinal surgery were documented. The outcome parameters were length of stay in the intensive care unit (iLOS) and length of stay (LOS) in the hospital, duration of mechanical ventilation, onset of sepsis, multiple organ dysfunction syndrome and mortality.
Results. 143 polytrauma patients with cervical spine fracture and a complete dataset were included. The mean ISS was 25.8. In 38 patients the upper cervical spine and in 111 the subaxial cervical spine was involved. 17 A-type injuries, 26 were classified as B-/C-type injuries. 21 injuries at the C2- and 1 injury at C1-level were identified. Neurological impairment was observed in 31cases. Older patients more often showed fractures in the upper cervical spine without correlation between cervical spine injury with neurological impairment and age. Cervical fracture location did not correlate with severe head and face trauma, whereas severe thoracic trauma is associated with fracture at the lower cervical spine. Patients surgically treated within 24 hours showed a significantly reduced LOS; but an increased time to spinal surgery was not an independent risk factor for the development of MODS, sepsis or death.
Conclusion. Our data showed no significance of early spinal cervical stabilization regarding improvement of neurological impairment beneficial impact on the onset of MODS, sepsis and death.
No
Auf unserem Internetauftritt verwenden wir Cookies. Bei Cookies handelt es sich um kleine (Text-)Dateien, die auf Ihrem Endgerät (z.B. Smartphone, Notebook, Tablet, PC) angelegt und gespeichert werden. Einige dieser Cookies sind technisch notwendig um die Webseite zu betreiben, andere Cookies dienen dazu die Funktionalität der Webseite zu erweitern oder zu Marketingzwecken. Abgesehen von den technisch notwendigen Cookies, steht es Ihnen frei Cookies beim Besuch unserer Webseite zuzulassen oder nicht.