Full Papper COE Bali
DESCRIPTIVE OF SPINE TRAUMA CASES AT SANGLAH HOSPITAL
JANUARY – DECEMBER 2013
dr Nyoman Gde Aditya Gitapradita B
dr IGNA Lanang Artha Wiguna SpOT (K)
Department Of Orthopaedic and Traumatology
DESCRIPTIVE OF SPINE TRAUMA CASES AT SANGLAH HOSPITAL JANUARY – DECEMBER 2013
Background
Spine fractures account for a large portion of musculoskeletal injuries worldwide. The prevalence of cervical spine fracture in trauma victims depends on the demographics of the
population served by a trauma center. In general, approximately 2% to 6% of trauma patients
sustain a cervical spine fracture. Of those trauma patients sustaining a spinal injury, more
than half of the spinal injuries involve the cervical region. The annual rate of trauma-related
thoracic and lumbar fractures is approximately 15,000. Thoracic and lumbar fractures
account for 30% to 50% of all spinal injuries in trauma victims.4 Approximately 75% to 90% of spinal fractures occur in the thoracic and lumbar spine, with most of these occurring at the thoracolumbar junction (T10-L2).2 Injuries to the cervical spine are common following trauma. The upper cervical vertebrae (C1 and C2) are the most frequent sites of fracture in
the cervical. Spine Fractures of C6 and C7 account for nearly 40% of subaxial cervical spine
injuries after blunt trauma.4 Some degree of neurologic deficit occurs in 10% to 25% of
patients at all levels of injury in 40% at cervical spine levels, and in 15% to 20% at
thoracolumbar levels.7
The incidence of spinal cord injury (SCI) in the United Stated has been estimated at
15-40 per million population. The incidence of neurologic injury associated with all spine
fracture and dislocation is approximately 14%; the incidence is 39%% among patient with
cervical level injury.8 Data from Sweden from 1987-1999 indicate that, although over all
number of cervical fracture has decreased, there has been an increase in the prevalence of this
injury in older adult population. As might be expected, the mechanism of motor vehicle
crashes plays a lesser role in cervical injuries in older adults,whereas falls as the mechanism
of injury play greater role.9 In Sweden, with a population of 9.2 million, about 2,700 patients
with thoracolumbar vertebral fractures are admitted to hospitals annually. Most of these
fractures are caused by blunt trauma. In younger patients, thoracolumbarvertebral fractures
are usually caused by high energy accidents such as falls, or motor vehicle accidents whereas
in elderly patients, osteoporosis is the dominant etiology.3 The causes of spinal column and
spinal cord injury are illustrated in The most significant cause of spinal column injury is
motor vehicle accidents (45%), followed by falls (20%), sports-related accidents (15%), acts
of violence (15%), and miscellaneous causes (5%). At the extremes of age, the role of falls
male-to-female ratio is 4:1. When a neurologic deficit is associated with spinal column
injury, the overall survival rate for all levels of injury is 86% at 10 years.7
There was no history evaluation descriptive of spine trauma cases at sanglah hospital,
therefore there is no data of incidence spine trauma based on age, sex, month, treatment,
