Introduction: Cervical spine fracture is assumed of all trauma patients until proven otherwise due to the conditions’ potential for permanent disability. However, actual rates of cervical fractures have not been reported with sufficient power.
Methods: To identify trauma cases, we searched the NIS databases using HCUP-supplied External Sources of Injury (E-Codes), which also identified cause of injury (Falls, Motor Vehicle, Assault, etc.). Yearly incidence of cervical trauma (ICD-9 805* and 806*) was calculated using hospital year and trend weights and by dividing the frequencies of cervical fracture by all selected injuries. Cord injuries, neurological complications, and level of the fracture were queried using ICD-9 codes and analyzed by t test.
Results: 463,631 patients (average age: 58.1, 60% male) sustained a traumatic cervical fracture in the NIS database from 2005 to 2013. Total numbers of trauma admission and blunt trauma resulting in cervical fracture increased between years 2005 (38,009 cervical fracture [4.4% incidence]) and 2013 (55,700 cervical fracture [5.8% incidence]), p<0.001. When looking at trends of the causes of cervical fractures from 2005 to 2013 there was an observed steady decline in “Car Crash” from 34% in 2005 to 25.5% in 2013, p<0.001. Alternatively, there was an observed increase in “Falls” and “Struck Pedestrian” as the cause for cervical fractures from 2005 to 2013; 19% to 27% and 13.5% to 18%, respectively, both p<0.001. In measuring spinal cord injury, incidence was 4.99% upper cervical spine (levels 1-4) cervical fractures and 6.83% in lower cervical spine fractures. 0.76% of patients were diagnosed with quadriplegia and 1.57% with Cauda Equina, p<0.001.
Conclusions: We observed there has been a steady decline in the number of patients who are suffering cervical fractures from motor vehicle accidents (8.5%). Concurrently, both falling and pedestrian-struck cervical fractures increased over the last ten years, 8% and 5.5% respectively.
Patient Care: This research will increase the awareness of the causes of cervical spine fractures and could help stop preventable injuries from occurring as well as gives insight into concurrent spinal cord injuries.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) describe the trends in cervical spine fractures in the United States in the past decade, 2) identify most common causes of cervical spine fractures.