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High Energy Spine Injury Alternate Multiple Fractures Observational Retrospective Study

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Abstract

Multiple alternate fractures are those that present injuries at several levels of the spine separated by at least one healthy vertebral body. A posttraumatic prevalence of up to 23% is reported.3–5 There are no reports in Argentina. The purpose of this study is to report the prevalence of multiple alternate spine fractures in five hospitals of the City of Buenos Aires, Argentina, and evaluate its connection to other relevant characteristics. Inclusion criteria involve acute fractures of the spine. Classifications used were the following: cervical subaxial8 and thoracolumbar9 AO, Anderson for odontoids,15, 16 Effendi Laurin17 and Geweiler,18, 19 ASIA,20, 21 and Frankel.22 Statistical analysis consists of two groups: “Alternate” and “Contiguous.” Sample distribution, Shapiro-Wilk or Kolmogorov Smirnov test, was used. In comparison of continuous variables, “Student’s t-test or the Mann-Whitney U test” was used. To compare the categorical variables, Chi2 test or Fisher’s exact test was used. In data analysis, IBM SPSS Macintosh software, version 24.0 (IBM Corp., Armonk, NY, USA), was used. From the five hospitals of Buenos Aires, 514 medical records were reviewed, and 120 patients included, from April 2007 to April 2017. Of the total of spine fractures, 56 (46.7%) were simple, 35 (29.2%) were multiple contiguous, and 29 (24.1%) were multiple alternate. Fifty-four (45%) patients were women, average age of the sample: 40 years old. Within the group of multiple alternate fractures, the cervical area was the most affected in 16 (55.1%) patients. Fractures of nine (31%) patients of the Alternate group were related to a labor accident (9.9% contiguous, significant p = 0.02). Fourteen (48.3%) patients of the Alternate group presented an associated injury (23 patients [25.3%] of the contiguous fractures, with significance p = 0.02). As regards the International Publications, the prevalence of multiple alternate fractures was 24.1% (17 or 19%)4, 5, 23, 24 with similar production mechanism, male predominance, and an average of 40 years old.3, 5, 23 The location was similar: cervico-thoracic 24.1%. One in four patients admitted in our centers, with a spine fracture, had at least other vertebrae fractured at a distance. These were associated with neurological alterations, extra-spinal injuries, and labor accidents.

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Acknowledgments

Paula Goñi, Technical Scientific Literary English Translator, and Adriana Mateos, Technical Scientific Literary English Translator.

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Authors and Affiliations

  1. Vertebral Column Surgery Service, Hospital Gral de Agudos C.G. Durand Buenos Aires, av. Juan B. Justo 8240 (1407), CABA, Argentina

    Aníbal José Sarotto, José Rosado Pardo, Fernando Tillet & Micaela Besse

  2. Orthopedics and Traumatology Service, Sanatorio V. Franchin, CABA, Argentina

    Aníbal José Sarotto, Jorge Paulus Astiasarán, Ricardo Baldassarre, José Rosado Pardo, Leandro Ambrosini & Micaela Besse

  3. Orthopedics and Traumatology Service, Hospital Militar Central C. Argerich Buenos Aires, CABA, Argentina

    Jorge Paulus Astiasarán, Alejandro Steverlynck, Roberto Castelli, Diego Ponte, Dino Dinelli, Diego Sobrero, Nicolás Scheverin & Edward Romero

  4. Orthopedics and Traumatology Service, Sanatorio Julio Mendez Buenos Aires, CABA, Argentina

    Roberto Muscia & Diego Gandara

  5. Orthopedics and Traumatology Service, Hospital de Clínicas General San Martín UBA, CABA, Argentina

    Luis M. Melo

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  1. Aníbal José Sarotto
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Corresponding author

Correspondence to Aníbal José Sarotto.

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The authors declare that they have no conflict(s) of interest.

Ethical Approval

This study was evaluated and accepted by the ethics committee of the “Sociedad Argentina de Patología de la Columna Vertebral,” according to the current national regulations.

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The informed consent of the patients was not necessary given the retrospective nature of the study.

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Level of Evidence

IV (case series)

This article is part of the Topical Collection on Surgery

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Sarotto, A.J., Astiasarán, J.P., Steverlynck, A. et al. High Energy Spine Injury Alternate Multiple Fractures Observational Retrospective Study. SN Compr. Clin. Med. 2, 75–81 (2020). https://doi.org/10.1007/s42399-019-00212-z

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