The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine Vol. 20; no. 1; p. 85
• Main Authors: Fredø, Hege Linnerud, Rizvi, Syed Ali Mujtaba, Lied, Bjarne, Rønning, Pål, Helseth, Eirik
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.12.2012; Springer Nature B.V; BioMed Central; BMC
• Subjects: Accidental Falls - statistics & numerical data; Accidents, Traffic - statistics & numerical data; Adolescent; Adult; Age groups; Aged; Aged, 80 and over; Arthritis; Bicycling; Bicycling - injuries; Cervical vertebrae; Cervical Vertebrae - injuries; Child; Child, Preschool; Comorbidity; Cycling; Epidemiology; Falls; Female; Fractures; Head injuries; Health aspects; Humans; Incidence; Male; Males; Middle Aged; Mortality; Norway; Norway - epidemiology; Original Research; Prospective Studies; Spinal cord injuries; Spinal fractures; Spinal Fractures - epidemiology; Spine; Spondylitis, Ankylosing - epidemiology; Trauma; Trauma centers; Vehicles; Young Adult; Norway
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/1757-7241-20-85

The aim of this study was to estimate the incidence of traumatic cervical spine fractures (CS-fx) in a general population. The incidence of CS-fx in the general population is largely unknown. All CS-fx (C0/C1 to C7/Th1) patients diagnosed with cervical-CT in Southeast Norway (2.7 million inhabitants) during the time period from April 27, 2010-April 26, 2011 were prospectively registered in this observational cohort study. Over a one-year period, 319 patients with CS-fx at one or more levels were registered, constituting an estimated incidence of 11.8/100,000/year. The median age of the patients was 56 years (range 4-101 years), and 68% were males. The relative incidence of CS-fx increased significantly with age. The trauma mechanisms were falls in 60%, motorized vehicle accidents in 21%, bicycling in 8%, diving in 4% and others in 7% of patients. Neurological status was normal in 79%, 5% had a radiculopathy, 8% had an incomplete spinal cord injury (SCI), 2% had a complete SCI, and neurological function could not be determined in 6%. The mortality rates after 1 and 3 months were 7 and 9%, respectively. Among 319 patients, 26.6% were treated with open surgery, 68.7% were treated with external immobilization with a stiff collar and 4.7% were considered stable and not in need of any specific treatment. The estimated incidence of surgically treated CS-fx in our population was 3.1/100,000/year. This study estimates the incidence of traumatic CS-fx in a general Norwegian population to be 11.8/100,000/year. A male predominance was observed and the incidence increased with increasing age. Falls were the most common trauma mechanism, and SCI was observed in 10%. The 1- and 3-month mortality rates were 7 and 9%, respectively. The incidence of open surgery for the fixation of CS-fx in this population was 3.1/100,000/year. This is a prospective observational cohort study and level II-2 according to US Preventive Services Task Force.