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J Spinal Disord Tech. 2013 Oct;26(7):E272-6. doi: 10.1097/BSD.0b013e31828674b1.

Multiple-level noncontiguous spinal fractures: difference between the young and the elderly.

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  • 1Departments of *Orthopaedics, Xinqiao Hospital †Traumatology, Southwest Hospital, The Third Military Medical University, Chongqing, P.R. China.

Abstract

STUDY DESIGN:

We retrospectively reviewed the hospital records of all patients with multiple-level noncontiguous spinal fractures (MLNSF) at university-affiliated hospitals between January 2001 and May 2011 (n=213). The variables assessed included age, sex, spinal fracture mechanism, anatomic distribution, neurological deficit, and associated injury.

OBJECTIVE:

The purpose of our study was to better understand the patterns of MLNSF, with an emphasis on comparing young and elderly patients.

SUMMARY OF BACKGROUND DATA:

There are many studies on the characteristics of noncontiguous spinal fractures, but these existing studies do not differentiate between young and elderly patients with noncontiguous spinal fractures.

RESULTS:

A total of 213 patients with MLNSF were enrolled, of whom 57.3% (122/213) were male and 67.1% (143/213) were young patients (age less than 60 y). Accidental falls from a high height and road traffic crashes were the most common injuries leading to spinal fractures (44.1% and 22.4%, respectively) among young patients, whereas osteoporotic spinal fractures and accidental falls from a low height (38.6% and 28.6%, respectively) were the most common causes of spinal injuries among elderly patients. The most common region suffering MLNSF among young patients was the thoracic+lumbar region (36.4%), followed by the cervical+thoracic region (23.8%). Among elderly patients, the thoracic+lumbar region (52.9%) followed by the thoracic+thoracic region (35.7%) were the most common regions suffering MLNSF. The frequency of neurological deficit was significantly different between the young and the elderly patients (57.3% and 21.4%, respectively). A total of 73 (51.0%, 73/143) young patients had associated nonspinal injuries, and 9 (12.9%, 9/70) elderly patients had such injuries.

CONCLUSIONS:

Of all the patients with MLNSF, the risk of noncontiguous spinal fractures with neurological deficit and associated injuries in the elderly patients was lower than that among young patients. The thoracic+lumbar region was the most common region of injury among all patients, and the cervical+thoracic region was more commonly injured among young patients. Clinicians should make their diagnoses and direct their injury prevention strategies according to the characteristics of MLNSF in a specific age group.

PMID:
23511651
[PubMed - indexed for MEDLINE]
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