Cervical spine injuries in motor vehicle accidents C. W. Müller, D. Otte, C. Haasper, J. Nehmzow, C. Probst, T. Stübig, T. Hüfner and C. Krettek Trauma.

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Presentation transcript:

Cervical spine injuries in motor vehicle accidents C. W. Müller, D. Otte, C. Haasper, J. Nehmzow, C. Probst, T. Stübig, T. Hüfner and C. Krettek Trauma Departement and Accident Research Unit Hanover Medical School, D Hannover, Germany P77

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Introduction: Epidemiology of spinal trauma  severe spinal injuries in Germany per year (20% cervical spine) 1  traumatic vertebral fractures and 10 to spinal cord injuries per year in the US 2  Predominant causes in Europe: Traffic accidents, falls from great height, sports injury 1 1 Bühren, V Buchowski, JM 2008

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS M&M: Study Design  Within 20 years a local accident research unit recorded technical and medical details of traffic accidents according to a sample plan representative for all traffic accidents in Germany 1  The data bank was screened for front passengers with spinal injuries  Hospital charts and x-rays were reviewed  Patterns of injuries and technical details were analyzed 1 Richter, M 2007

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Results: Spinal injuries (0,53%) (0,28%) (0,31%)

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Results: Age mean: 35.5 y 35.1 y 37.0 y 38.4 y

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Results: Collision type

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Results: Impact velocity (delta-v) (0,53%) (0,28%) (0,31%)

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Results: Injury Severity (AIS *1 )/ Additional Injuries 1 Automotive Assoc., 1990

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Discussion: Injury mechanism  Side impacts, rollovers and multiple collisions are more frequent injury mechanisms  Head is insufficiently protected in these situations  High torsion forces of the cervical spine  Side airbags might be helpful but were infrequent in this cohort

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Discussion: Trauma severity & concomitant injuries  Nearly all patients with fractures of the cervical spine had concomitant injuries, including additional spinal fractures  Winslow: Injury of the cervical spine doubles risk for thoracolumbar fractures 1  Ball: 57% concomitant intraabdominal injuries in spine fractures following frontal impact 2 1 Winslow, JE Ball, ST 2000

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Summary  Cervical spine injuries are the most frequentspinal injuries in traffic accidents  Concomitant injuries are frequent in patients with cervical spine fracture  Side impacts, rollovers and multiple collisions are disproportionately frequent causes

Unfallchirurgische Klinik Prof. Dr. C. Krettek,FRACS Disclosure: The accident research unit is in part funded by a government institution (Bundesanstalt für Straßenwesen, BASt). None of the authors has any other potential conflicting interest to disclose.