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Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2014

Open Access 01-12-2014 | Original research

Incidence of traumatic cervical spine fractures in the Norwegian population: a national registry study

Authors: Hege L Fredø, Inger J Bakken, Bjarne Lied, Pål Rønning, Eirik Helseth

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2014

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Abstract

Background

The incidence of cervical spine fractures (CS-fx) in the general population is sparingly assessed. The aim of the current study was to estimate the incidence of traumatic CS-fx and of open surgery of cervical spine injuries in the Norwegian population.

Methods

The Norwegian Patient Register (NPR) is an administrative database that contains activity data from all Norwegian government-owned hospitals and outpatient clinics. The diagnoses and procedures are coded according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the NOMESCO Classification of Surgical Procedures (NCSP), respectively. We retrieved information on all severe traumatic cervical spine injuries between 2009 and 2012 from the NPR. Updated information on the date of death is included through routine linkage to the General Register Office.

Results

Between 2009 and 2012, a total of 3 248 patients met our criteria for severe traumatic cervical spine injury. A total of 2 963 patients had one or more CS-fx, and 285 had severe non-fracture cervical spine injuries. The median age was 54 years, and 69% of the patients were male. The incidence of CS-fx and severe non-fracture injuries in the total Norwegian population was 16.5/100 000/year, and the incidence of CS-fx was 15.0/100 000/year. A total of 18% of the patients were treated with open surgery, resulting in an estimated incidence of surgery for acute traumatic cervical spine injury of 3.0/100 000/ year in the Norwegian population. The 1- and 3-month mortality rates were 4% and 6%, respectively.
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Literature
1.
go back to reference Brolin K, von Holst H: Cervical injuries in Sweden, a national survey of patient data from 1987 to 1999. Inj Control Saf Promot. 2002, 9: 40-52. 10.1076/icsp.9.1.40.3318.CrossRefPubMed Brolin K, von Holst H: Cervical injuries in Sweden, a national survey of patient data from 1987 to 1999. Inj Control Saf Promot. 2002, 9: 40-52. 10.1076/icsp.9.1.40.3318.CrossRefPubMed
2.
go back to reference Hu R, Mustard CA, Burns C: Epidemiology of incident spinal fracture in a complete population. Spine (Phila Pa 1976). 1996, 21: 492-499. 10.1097/00007632-199602150-00016.CrossRef Hu R, Mustard CA, Burns C: Epidemiology of incident spinal fracture in a complete population. Spine (Phila Pa 1976). 1996, 21: 492-499. 10.1097/00007632-199602150-00016.CrossRef
3.
go back to reference Fredo HL, Rizvi SA, Lied B, Ronning P, Helseth E: The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway. Scand J Trauma Resusc Emerg Med. 2012, 20: 85-10.1186/1757-7241-20-85.PubMedCentralCrossRefPubMed Fredo HL, Rizvi SA, Lied B, Ronning P, Helseth E: The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway. Scand J Trauma Resusc Emerg Med. 2012, 20: 85-10.1186/1757-7241-20-85.PubMedCentralCrossRefPubMed
4.
go back to reference Yanar H, Demetriades D, Hadjizacharia P, Nomoto S, Salim A, Inaba K, Rhee P, Chan LS: Pedestrians injured by automobiles: risk factors for cervical spine injuries. J Am Coll Surg. 2007, 205: 794-799. 10.1016/j.jamcollsurg.2007.06.280.CrossRefPubMed Yanar H, Demetriades D, Hadjizacharia P, Nomoto S, Salim A, Inaba K, Rhee P, Chan LS: Pedestrians injured by automobiles: risk factors for cervical spine injuries. J Am Coll Surg. 2007, 205: 794-799. 10.1016/j.jamcollsurg.2007.06.280.CrossRefPubMed
5.
go back to reference Williams J, Jehle D, Cottington E, Shufflebarger C: Head, facial, and clavicular trauma as a predictor of cervical-spine injury. Ann Emerg Med. 1992, 21: 719-722. 10.1016/S0196-0644(05)82786-6.CrossRefPubMed Williams J, Jehle D, Cottington E, Shufflebarger C: Head, facial, and clavicular trauma as a predictor of cervical-spine injury. Ann Emerg Med. 1992, 21: 719-722. 10.1016/S0196-0644(05)82786-6.CrossRefPubMed
6.
go back to reference Thompson WL, Stiell IG, Clement CM, Brison RJ: Association of injury mechanism with the risk of cervical spine fractures. CJEM. 2009, 11: 14-22.PubMed Thompson WL, Stiell IG, Clement CM, Brison RJ: Association of injury mechanism with the risk of cervical spine fractures. CJEM. 2009, 11: 14-22.PubMed
7.
go back to reference Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Ma V, Laupacis A, Schull M, McKnight RD, Verbeek R, Brison R, Cass D, Dreyer J, Eisenhauer MA, Greenberg GH, MacPhail I, Morrison L, Reardon M, Worthington J: The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001, 286: 1841-1848. 10.1001/jama.286.15.1841.CrossRefPubMed Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Ma V, Laupacis A, Schull M, McKnight RD, Verbeek R, Brison R, Cass D, Dreyer J, Eisenhauer MA, Greenberg GH, MacPhail I, Morrison L, Reardon M, Worthington J: The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001, 286: 1841-1848. 10.1001/jama.286.15.1841.CrossRefPubMed
8.
go back to reference Schoenfeld AJ, Sielski B, Rivera KP, Bader JO, Harris MB: Epidemiology of cervical spine fractures in the US military. Spine J. 2012, 12: 777-783. 10.1016/j.spinee.2011.01.029.CrossRefPubMed Schoenfeld AJ, Sielski B, Rivera KP, Bader JO, Harris MB: Epidemiology of cervical spine fractures in the US military. Spine J. 2012, 12: 777-783. 10.1016/j.spinee.2011.01.029.CrossRefPubMed
9.
go back to reference Sanchez B, Waxman K, Jones T, Conner S, Chung R, Becerra S: Cervical spine clearance in blunt trauma: evaluation of a computed tomography-based protocol. J Trauma. 2005, 59: 179-183. 10.1097/01.TA.0000171449.94650.81.CrossRefPubMed Sanchez B, Waxman K, Jones T, Conner S, Chung R, Becerra S: Cervical spine clearance in blunt trauma: evaluation of a computed tomography-based protocol. J Trauma. 2005, 59: 179-183. 10.1097/01.TA.0000171449.94650.81.CrossRefPubMed
10.
go back to reference Roberge RJ, Wears RC, Kelly M, Evans TC, Kenny MA, Daffner RD, Kremen R, Murray K, Cottington EC: Selective application of cervical spine radiography in alert victims of blunt trauma: a prospective study. J Trauma. 1988, 28: 784-788. 10.1097/00005373-198806000-00010.CrossRefPubMed Roberge RJ, Wears RC, Kelly M, Evans TC, Kenny MA, Daffner RD, Kremen R, Murray K, Cottington EC: Selective application of cervical spine radiography in alert victims of blunt trauma: a prospective study. J Trauma. 1988, 28: 784-788. 10.1097/00005373-198806000-00010.CrossRefPubMed
11.
go back to reference O’Malley KF, Ross SE: The incidence of injury to the cervical spine in patients with craniocerebral injury. J Trauma. 1988, 28: 1476-1478. 10.1097/00005373-198810000-00013.CrossRefPubMed O’Malley KF, Ross SE: The incidence of injury to the cervical spine in patients with craniocerebral injury. J Trauma. 1988, 28: 1476-1478. 10.1097/00005373-198810000-00013.CrossRefPubMed
12.
go back to reference Mulligan RP, Friedman JA, Mahabir RC: A nationwide review of the associations among cervical spine injuries, head injuries, and facial fractures. J Trauma. 2010, 68: 587-592. 10.1097/TA.0b013e3181b16bc5.CrossRefPubMed Mulligan RP, Friedman JA, Mahabir RC: A nationwide review of the associations among cervical spine injuries, head injuries, and facial fractures. J Trauma. 2010, 68: 587-592. 10.1097/TA.0b013e3181b16bc5.CrossRefPubMed
13.
go back to reference Michael DB, Guyot DR, Darmody WR: Coincidence of head and cervical spine injury. J Neurotrauma. 1989, 6: 177-189. 10.1089/neu.1989.6.177.CrossRefPubMed Michael DB, Guyot DR, Darmody WR: Coincidence of head and cervical spine injury. J Neurotrauma. 1989, 6: 177-189. 10.1089/neu.1989.6.177.CrossRefPubMed
14.
go back to reference Lowery DW, Wald MM, Browne BJ, Tigges S, Hoffman JR, Mower WR: Epidemiology of cervical spine injury victims. Ann Emerg Med. 2001, 38: 12-16. 10.1067/mem.2001.116149.CrossRefPubMed Lowery DW, Wald MM, Browne BJ, Tigges S, Hoffman JR, Mower WR: Epidemiology of cervical spine injury victims. Ann Emerg Med. 2001, 38: 12-16. 10.1067/mem.2001.116149.CrossRefPubMed
15.
go back to reference Hoffman JR, Schriger DL, Mower W, Luo JS, Zucker M: Low-risk criteria for cervical-spine radiography in blunt trauma: a prospective study. Ann Emerg Med. 1992, 21: 1454-1460. 10.1016/S0196-0644(05)80059-9.CrossRefPubMed Hoffman JR, Schriger DL, Mower W, Luo JS, Zucker M: Low-risk criteria for cervical-spine radiography in blunt trauma: a prospective study. Ann Emerg Med. 1992, 21: 1454-1460. 10.1016/S0196-0644(05)80059-9.CrossRefPubMed
16.
go back to reference Hills MW, Deane SA: Head injury and facial injury: is there an increased risk of cervical spine injury?. J Trauma. 1993, 34: 549-553. 10.1097/00005373-199304000-00011.CrossRefPubMed Hills MW, Deane SA: Head injury and facial injury: is there an increased risk of cervical spine injury?. J Trauma. 1993, 34: 549-553. 10.1097/00005373-199304000-00011.CrossRefPubMed
17.
go back to reference Clayton JL, Harris MB, Weintraub SL, Marr AB, Timmer J, Stuke LE, McSwain NE, Duchesne JC, Hunt JP: Risk factors for cervical spine injury. Injury. 2012, 43: 431-435. 10.1016/j.injury.2011.06.022.CrossRefPubMed Clayton JL, Harris MB, Weintraub SL, Marr AB, Timmer J, Stuke LE, McSwain NE, Duchesne JC, Hunt JP: Risk factors for cervical spine injury. Injury. 2012, 43: 431-435. 10.1016/j.injury.2011.06.022.CrossRefPubMed
18.
go back to reference Cirak B, Ziegfeld S, Knight VM, Chang D, Avellino AM, Paidas CN: Spinal injuries in children. J Pediatr Surg. 2004, 39: 607-612. 10.1016/j.jpedsurg.2003.12.011.CrossRefPubMed Cirak B, Ziegfeld S, Knight VM, Chang D, Avellino AM, Paidas CN: Spinal injuries in children. J Pediatr Surg. 2004, 39: 607-612. 10.1016/j.jpedsurg.2003.12.011.CrossRefPubMed
19.
go back to reference Brown RL, Brunn MA, Garcia VF: Cervical spine injuries in children: a review of 103 patients treated consecutively at a level 1 pediatric trauma center. J Pediatr Surg. 2001, 36: 1107-1114. 10.1053/jpsu.2001.25665.CrossRefPubMed Brown RL, Brunn MA, Garcia VF: Cervical spine injuries in children: a review of 103 patients treated consecutively at a level 1 pediatric trauma center. J Pediatr Surg. 2001, 36: 1107-1114. 10.1053/jpsu.2001.25665.CrossRefPubMed
21.
go back to reference World Health Organization: ICD-10: International Statistical Classification of Diseases and Related Health Problems. 2009, WHO, Geneva World Health Organization: ICD-10: International Statistical Classification of Diseases and Related Health Problems. 2009, WHO, Geneva
22.
go back to reference Nordic Medico-Statistical Committee (NOMESCO): NOMESCO Classification of Surgical Procedures. 2010, NOMESCO, Copenhagen Nordic Medico-Statistical Committee (NOMESCO): NOMESCO Classification of Surgical Procedures. 2010, NOMESCO, Copenhagen
23.
go back to reference Bucholz RW, Burkhead WZ, Graham W, Petty C: Occult cervical spine injuries in fatal traffic accidents. J Trauma. 1979, 19: 768-771. 10.1097/00005373-197910000-00009.CrossRefPubMed Bucholz RW, Burkhead WZ, Graham W, Petty C: Occult cervical spine injuries in fatal traffic accidents. J Trauma. 1979, 19: 768-771. 10.1097/00005373-197910000-00009.CrossRefPubMed
24.
go back to reference Alker GJ, Oh YS, Leslie EV, Lehotay J, Panaro VA, Eschner EG: Postmortem radiology of head neck injuries in fatal traffic accidents. Radiology. 1975, 114: 611-617. 10.1148/114.3.611.CrossRefPubMed Alker GJ, Oh YS, Leslie EV, Lehotay J, Panaro VA, Eschner EG: Postmortem radiology of head neck injuries in fatal traffic accidents. Radiology. 1975, 114: 611-617. 10.1148/114.3.611.CrossRefPubMed
25.
go back to reference Soreide K, Kruger AJ, Vardal AL, Ellingsen CL, Soreide E, Lossius HM: Epidemiology and contemporary patterns of trauma deaths: changing place, similar pace, older face. World J Surg. 2007, 31: 2092-2103. 10.1007/s00268-007-9226-9.CrossRefPubMed Soreide K, Kruger AJ, Vardal AL, Ellingsen CL, Soreide E, Lossius HM: Epidemiology and contemporary patterns of trauma deaths: changing place, similar pace, older face. World J Surg. 2007, 31: 2092-2103. 10.1007/s00268-007-9226-9.CrossRefPubMed
26.
go back to reference McCabe JB, Angelos MG: Injury to the head and face in patients with cervical spine injury. Am J Emerg Med. 1984, 2: 333-335. 10.1016/0735-6757(84)90130-X.CrossRefPubMed McCabe JB, Angelos MG: Injury to the head and face in patients with cervical spine injury. Am J Emerg Med. 1984, 2: 333-335. 10.1016/0735-6757(84)90130-X.CrossRefPubMed
27.
go back to reference Kattail D, Furlan JC, Fehlings MG: Epidemiology and clinical outcomes of acute spine trauma and spinal cord injury: experience from a specialized spine trauma center in Canada in comparison with a large national registry. J Trauma. 2009, 67: 936-943. 10.1097/TA.0b013e3181a8b431.CrossRefPubMed Kattail D, Furlan JC, Fehlings MG: Epidemiology and clinical outcomes of acute spine trauma and spinal cord injury: experience from a specialized spine trauma center in Canada in comparison with a large national registry. J Trauma. 2009, 67: 936-943. 10.1097/TA.0b013e3181a8b431.CrossRefPubMed
28.
go back to reference Jackson AB, Dijkers M, Devivo MJ, Poczatek RB: A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil. 2004, 85: 1740-1748. 10.1016/j.apmr.2004.04.035.CrossRefPubMed Jackson AB, Dijkers M, Devivo MJ, Poczatek RB: A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil. 2004, 85: 1740-1748. 10.1016/j.apmr.2004.04.035.CrossRefPubMed
29.
go back to reference Holly LT, Kelly DF, Counelis GJ, Blinman T, McArthur DL, Cryer HG: Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics. J Neurosurg. 2002, 96: 285-291.PubMed Holly LT, Kelly DF, Counelis GJ, Blinman T, McArthur DL, Cryer HG: Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics. J Neurosurg. 2002, 96: 285-291.PubMed
30.
go back to reference Ryan MD, Henderson JJ: The epidemiology of fractures and fracture-dislocations of the cervical spine. Injury. 1992, 23: 38-40. 10.1016/0020-1383(92)90123-A.CrossRefPubMed Ryan MD, Henderson JJ: The epidemiology of fractures and fracture-dislocations of the cervical spine. Injury. 1992, 23: 38-40. 10.1016/0020-1383(92)90123-A.CrossRefPubMed
31.
go back to reference Bohlman HH: Acute fractures and dislocations of the cervical spine. an analysis of three hundred hospitalized patients and review of the literature. J Bone Joint Surg Am. 1979, 61: 1119-1142.PubMed Bohlman HH: Acute fractures and dislocations of the cervical spine. an analysis of three hundred hospitalized patients and review of the literature. J Bone Joint Surg Am. 1979, 61: 1119-1142.PubMed
32.
go back to reference Leucht P, Fischer K, Muhr G, Mueller EJ: Epidemiology of traumatic spine fractures. Injury. 2009, 40: 166-172. 10.1016/j.injury.2008.06.040.CrossRefPubMed Leucht P, Fischer K, Muhr G, Mueller EJ: Epidemiology of traumatic spine fractures. Injury. 2009, 40: 166-172. 10.1016/j.injury.2008.06.040.CrossRefPubMed
33.
go back to reference Vaccaro AR, Hulbert RJ, Patel AA, Fisher C, Dvorak M, Lehman RAJ, Anderson P, Harrop J, Oner FC, Arnold P, Fehlings M, Hedlund R, Madrazo I, Rechtine G, Aarabi B, Shainline M: The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine (Phila Pa 1976). 2007, 32: 2365-2374. 10.1097/BRS.0b013e3181557b92.CrossRef Vaccaro AR, Hulbert RJ, Patel AA, Fisher C, Dvorak M, Lehman RAJ, Anderson P, Harrop J, Oner FC, Arnold P, Fehlings M, Hedlund R, Madrazo I, Rechtine G, Aarabi B, Shainline M: The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine (Phila Pa 1976). 2007, 32: 2365-2374. 10.1097/BRS.0b013e3181557b92.CrossRef
34.
go back to reference Sokolowski MJ, Jackson AP, Haak MH, Meyer PR, Szewczyk Sokolowski M: Acute outcomes of cervical spine injuries in the elderly: atlantaxial vs subaxial injuries. J Spinal Cord Med. 2007, 30: 238-242.PubMedCentralPubMed Sokolowski MJ, Jackson AP, Haak MH, Meyer PR, Szewczyk Sokolowski M: Acute outcomes of cervical spine injuries in the elderly: atlantaxial vs subaxial injuries. J Spinal Cord Med. 2007, 30: 238-242.PubMedCentralPubMed
35.
go back to reference Pull ter Gunne A, Aquarius AE, Roukema JA: Risk factors predicting mortality after blunt traumatic cervical fracture. Injury. 2008, 39: 1437-1441. 10.1016/j.injury.2008.03.008.CrossRefPubMed Pull ter Gunne A, Aquarius AE, Roukema JA: Risk factors predicting mortality after blunt traumatic cervical fracture. Injury. 2008, 39: 1437-1441. 10.1016/j.injury.2008.03.008.CrossRefPubMed
36.
go back to reference Harris JHJ, Edeiken-Monroe B, Kopaniky DR: A practical classification of acute cervical spine injuries. Orthop Clin North Am. 1986, 17: 15-30.PubMed Harris JHJ, Edeiken-Monroe B, Kopaniky DR: A practical classification of acute cervical spine injuries. Orthop Clin North Am. 1986, 17: 15-30.PubMed
Metadata
Title
Incidence of traumatic cervical spine fractures in the Norwegian population: a national registry study
Authors
Hege L Fredø
Inger J Bakken
Bjarne Lied
Pål Rønning
Eirik Helseth
Publication date
01-12-2014
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-014-0078-7

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