Introduction: Conventional wisdom suggests avoidance of aspirin in patients with vertebral fractures given concerns of impaired fusion. Yet patients who suffer cervical spine injuries may also have arterial injury, requiring antithrombotic therapy. We aimed to determine whether rates of fusion differ in patients treated with aspirin compared to those treated with other agents.
Methods: We performed retrospective analysis of all patients diagnosed with blunt arterial injury and unstable cervical spine fractures at our institution between January 2012 and January 2016. Patients were treated operatively or non-operatively, and were discharged on aspirin or enoxaparin. Imaging was obtained at 3 months following discharge.
Results: Of 62 patients, 26 (50%) were treated operatively and 26 (50%) non-operatively; 10 died and 15 were lost to follow-up. Eleven of 12 (92%) operative patients treated with aspirin had fusion at 3 months, compared to 2/2 (100%) patients treated with other anticoagulants (p = 0.85). Eleven of 15 (73%) non-operative patients treated with aspirin had fusion at 3 months, compared to 2/3 (66%) patients treated with other anticoagulants (p = 0.65).
Conclusions: This is an initial inquiry into whether any relationship exists between aspirin use and bone healing in cervical spine fractures. Our results suggest that 3-month fusion rates do not differ between patients treated with aspirin and other anticoagulants. We believe these data warrant further study.
Patient Care: Our research will offer a framework for considering antithrombotic therapy in trauma patients with vascular injury
Learning Objectives: By the conclusion of this session, participants should be able to 1.) Identify antithrombotic treatment options for patients with vascular injury and unstable spine fractures 2.) Understand the basis of controversy regarding the use of aspirin in these patients