A retrospective epidemiological study.
Landspítali University Hospital, Iceland.
Assessment of epidemiological data and risk factors for traumatic spinal fractures (SFs) and associated spinal cord injury (SCI).
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.
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%).
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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This study was supported by the Landspitali University Hospital Research Fund. The authors thank Sigrún Helga Lund for statistical advice.