Distracting injuries in patients with vertebral injuries

Cindy H. Chang, James F Holmes Jr, William R. Mower, Edward A Panacek

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

To describe the prevalence and types of distracting injuries associated with vertebral injuries at all levels of the spine in blunt trauma patients. A prospective cohort study was conducted at an urban Level I trauma center. All patients undergoing radiographic evaluation of the cervical, thoracic, or lumbar vertebrae after blunt trauma were enrolled. Patients had a data collection form completed by the treating physician before radiographic imaging and were evaluated for the following upon initial presentation: tenderness to the cervical, thoracic, or lumbar spine, distracting injuries, altered mental status, alcohol or drug intoxication, or neurological deficits. Patients with distracting injuries as the sole documented indication for vertebral radiographs were reviewed for the types of injuries present. A total of 4698 patients were enrolled in the study. There were 336 (7.2%) patients who had distracting injuries as the sole documented indication for obtaining radiographic studies of the vertebrae. Eight (2.4%, 95% CI 1.0-4.6%) of the 336 patients had 14 acute vertebral injuries including compression fractures (5), transverse process fractures (7), spinous process fracture (1), and cervical spine rotatory subluxation (1). There were 13 thoracolumbar injuries and one cervical spine injury. Distracting injuries in the eight patients with acute vertebral injuries included 13 bony fractures. Distracting injuries in those patients without vertebral injuries included bony fractures (333), lacerations (63), soft tissue contusions (62), head injuries (15), bony dislocations (12), abrasions (11), visceral injuries (8), dental injuries (5), burns (3), ligamentous injuries (3), amputation (1), and compartment syndrome (1). In conclusion, in patients with distracting injuries, bony fractures of any type were important for identifying patients with vertebral injuries. Other types of distracting injuries did not contribute to the sensitivity of the clinical screening criteria in the detection of patients with vertebral injuries.

Original languageEnglish (US)
Pages (from-to)147-152
Number of pages6
JournalJournal of Emergency Medicine
Volume28
Issue number2
DOIs
StatePublished - Feb 2005

Fingerprint

Wounds and Injuries
Spine
Tooth Injuries
Thoracic Vertebrae
Cervical Vertebrae
Compression Fractures
Compartment Syndromes
Lumbar Vertebrae
Contusions
Lacerations
Trauma Centers
Burns
Amputation
Craniocerebral Trauma
Cohort Studies
Thorax
Alcohols
Prospective Studies
Physicians

Keywords

  • Blunt trauma
  • Cervical spine
  • Distracting injury
  • Lumbar spine
  • Thoracic spine
  • Vertebral injury

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Distracting injuries in patients with vertebral injuries. / Chang, Cindy H.; Holmes Jr, James F; Mower, William R.; Panacek, Edward A.

In: Journal of Emergency Medicine, Vol. 28, No. 2, 02.2005, p. 147-152.

Research output: Contribution to journalArticle

@article{be697d27c7b54e5ea8733627ff92687f,
title = "Distracting injuries in patients with vertebral injuries",
abstract = "To describe the prevalence and types of distracting injuries associated with vertebral injuries at all levels of the spine in blunt trauma patients. A prospective cohort study was conducted at an urban Level I trauma center. All patients undergoing radiographic evaluation of the cervical, thoracic, or lumbar vertebrae after blunt trauma were enrolled. Patients had a data collection form completed by the treating physician before radiographic imaging and were evaluated for the following upon initial presentation: tenderness to the cervical, thoracic, or lumbar spine, distracting injuries, altered mental status, alcohol or drug intoxication, or neurological deficits. Patients with distracting injuries as the sole documented indication for vertebral radiographs were reviewed for the types of injuries present. A total of 4698 patients were enrolled in the study. There were 336 (7.2{\%}) patients who had distracting injuries as the sole documented indication for obtaining radiographic studies of the vertebrae. Eight (2.4{\%}, 95{\%} CI 1.0-4.6{\%}) of the 336 patients had 14 acute vertebral injuries including compression fractures (5), transverse process fractures (7), spinous process fracture (1), and cervical spine rotatory subluxation (1). There were 13 thoracolumbar injuries and one cervical spine injury. Distracting injuries in the eight patients with acute vertebral injuries included 13 bony fractures. Distracting injuries in those patients without vertebral injuries included bony fractures (333), lacerations (63), soft tissue contusions (62), head injuries (15), bony dislocations (12), abrasions (11), visceral injuries (8), dental injuries (5), burns (3), ligamentous injuries (3), amputation (1), and compartment syndrome (1). In conclusion, in patients with distracting injuries, bony fractures of any type were important for identifying patients with vertebral injuries. Other types of distracting injuries did not contribute to the sensitivity of the clinical screening criteria in the detection of patients with vertebral injuries.",
keywords = "Blunt trauma, Cervical spine, Distracting injury, Lumbar spine, Thoracic spine, Vertebral injury",
author = "Chang, {Cindy H.} and {Holmes Jr}, {James F} and Mower, {William R.} and Panacek, {Edward A}",
year = "2005",
month = "2",
doi = "10.1016/j.jemermed.2004.10.010",
language = "English (US)",
volume = "28",
pages = "147--152",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Distracting injuries in patients with vertebral injuries

AU - Chang, Cindy H.

AU - Holmes Jr, James F

AU - Mower, William R.

AU - Panacek, Edward A

PY - 2005/2

Y1 - 2005/2

N2 - To describe the prevalence and types of distracting injuries associated with vertebral injuries at all levels of the spine in blunt trauma patients. A prospective cohort study was conducted at an urban Level I trauma center. All patients undergoing radiographic evaluation of the cervical, thoracic, or lumbar vertebrae after blunt trauma were enrolled. Patients had a data collection form completed by the treating physician before radiographic imaging and were evaluated for the following upon initial presentation: tenderness to the cervical, thoracic, or lumbar spine, distracting injuries, altered mental status, alcohol or drug intoxication, or neurological deficits. Patients with distracting injuries as the sole documented indication for vertebral radiographs were reviewed for the types of injuries present. A total of 4698 patients were enrolled in the study. There were 336 (7.2%) patients who had distracting injuries as the sole documented indication for obtaining radiographic studies of the vertebrae. Eight (2.4%, 95% CI 1.0-4.6%) of the 336 patients had 14 acute vertebral injuries including compression fractures (5), transverse process fractures (7), spinous process fracture (1), and cervical spine rotatory subluxation (1). There were 13 thoracolumbar injuries and one cervical spine injury. Distracting injuries in the eight patients with acute vertebral injuries included 13 bony fractures. Distracting injuries in those patients without vertebral injuries included bony fractures (333), lacerations (63), soft tissue contusions (62), head injuries (15), bony dislocations (12), abrasions (11), visceral injuries (8), dental injuries (5), burns (3), ligamentous injuries (3), amputation (1), and compartment syndrome (1). In conclusion, in patients with distracting injuries, bony fractures of any type were important for identifying patients with vertebral injuries. Other types of distracting injuries did not contribute to the sensitivity of the clinical screening criteria in the detection of patients with vertebral injuries.

AB - To describe the prevalence and types of distracting injuries associated with vertebral injuries at all levels of the spine in blunt trauma patients. A prospective cohort study was conducted at an urban Level I trauma center. All patients undergoing radiographic evaluation of the cervical, thoracic, or lumbar vertebrae after blunt trauma were enrolled. Patients had a data collection form completed by the treating physician before radiographic imaging and were evaluated for the following upon initial presentation: tenderness to the cervical, thoracic, or lumbar spine, distracting injuries, altered mental status, alcohol or drug intoxication, or neurological deficits. Patients with distracting injuries as the sole documented indication for vertebral radiographs were reviewed for the types of injuries present. A total of 4698 patients were enrolled in the study. There were 336 (7.2%) patients who had distracting injuries as the sole documented indication for obtaining radiographic studies of the vertebrae. Eight (2.4%, 95% CI 1.0-4.6%) of the 336 patients had 14 acute vertebral injuries including compression fractures (5), transverse process fractures (7), spinous process fracture (1), and cervical spine rotatory subluxation (1). There were 13 thoracolumbar injuries and one cervical spine injury. Distracting injuries in the eight patients with acute vertebral injuries included 13 bony fractures. Distracting injuries in those patients without vertebral injuries included bony fractures (333), lacerations (63), soft tissue contusions (62), head injuries (15), bony dislocations (12), abrasions (11), visceral injuries (8), dental injuries (5), burns (3), ligamentous injuries (3), amputation (1), and compartment syndrome (1). In conclusion, in patients with distracting injuries, bony fractures of any type were important for identifying patients with vertebral injuries. Other types of distracting injuries did not contribute to the sensitivity of the clinical screening criteria in the detection of patients with vertebral injuries.

KW - Blunt trauma

KW - Cervical spine

KW - Distracting injury

KW - Lumbar spine

KW - Thoracic spine

KW - Vertebral injury

UR - http://www.scopus.com/inward/record.url?scp=13544265524&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13544265524&partnerID=8YFLogxK

U2 - 10.1016/j.jemermed.2004.10.010

DO - 10.1016/j.jemermed.2004.10.010

M3 - Article

VL - 28

SP - 147

EP - 152

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

SN - 0736-4679

IS - 2

ER -