Injuries significantly associated with thoracic spine fractures: a case-control study.

Emergency medicine Australasia : EMA

PubMedID: 19694786

Singh R, McD Taylor D, D'souza D, Gorelik A, Page P, Phal P. Injuries significantly associated with thoracic spine fractures: a case-control study. Emerg Med Australas. 2009;21(5):419-23.
OBJECTIVE
To determine injuries significantly associated with traumatic thoracic spine (T-spine) fractures

METHODS
This was a case-control study undertaken in an adult trauma centre. Cases were patients admitted with a traumatic T-spine fracture between January 1999 and August 2007. Each case had two controls matched for sex, age (+/-5 years) and injury severity classification (major/minor). Data were collected from patient medical records and the trauma service database. Multivariate logistic regression was used to determine injuries significantly associated with T-spine fracture.

RESULTS
Two hundred and sixty-one cases and 512 controls were enrolled. In both groups, mean age was 41 years and 70% of patients were male. Univariate analysis revealed a range of injuries that were significantly more common among the cases, especially cervical and lumbar spine injuries, sternal/scapular/clavicular/rib fractures, pneumo/haemothorax and pulmonary contusions (P < 0.01). Skull fractures and lower limb injuries were significantly more common among the controls (P < 0.01). Logistic regression analysis revealed that only cervical and lumbar spine injuries and rib fractures were positively associated with T-spine fracture (P < 0.001). Skull fractures and lower limb injuries were negatively associated with T-spine injury (P < 0.001).

CONCLUSION
Cervical and lumbar spine injuries and rib fractures are significantly associated with T-spine fracture. The presence of these injuries should raise suspicion of concomitant T-spine injury.