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Epidemiology of spinal fractures and associated spinal cord injuries in Iceland

Abstract

Study design

A retrospective epidemiological study.

Setting

Landspítali University Hospital, Iceland.

Objectives

Assessment of epidemiological data and risk factors for traumatic spinal fractures (SFs) and associated spinal cord injury (SCI).

Methods

A retrospective review of hospital admissions due to traumatic SFs during a 5-year period, with analysis of epidemiological parameters and occurrence of concomitant SCI. Patients with asymptomatic SFs and non-traumatic SCI were excluded.

Results

A total of 487 patients were diagnosed with a SF or 310 PMI (per million inhabitants), 42 of them (9%, 27 PMI) with an associated SCI. The mean age was 56 years, males were 57%. Falls were the leading cause of both SFs (49%) and SCIs (43%). Low falls (<1 m) caused SFs more often in elderly women (67%, mean age 77 years) and more than 96% were without SCI. Road traffic accidents (RTA) caused 31% of SFs and 26% of SCIs. Seat belts were not used in 20% of car accidents, but information was missing in 27%. Sports/leisure-related accidents caused SFs in 12% of cases, whereof horseback riding accidents were the most common (36%).

Conclusions

SFs led to SCI in 9% of patients. Several risk factors were common for SFs and SCIs but two major differences were seen: SFs without SCI were most common in older women due to low falls, while the risk of a concomitant SCI increased in young patients, in males, in falls from high levels and when driving without using seat belts. Preventive efforts should therefore be directed towards these risk factors.

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Acknowledgements

This study was supported by the Landspitali University Hospital Research Fund. The authors thank Sigrún Helga Lund for statistical advice.

Author information

Statement of ethics

We certify that all applicable institutional and governmental regulations concerning the ethical use of patient data were followed during the course of this research, including approval by the Ethical Committee and the Chief Medical Executive at Landspítali as well as the Icelandic Data Protection Authority.

Conflict of interest

The authors declare that they have no conflict of interest.

Correspondence to Páll E. Ingvarsson.

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