Epidemiology of thoracolumbar spine injury in blunt trauma.
OBJECTIVE
To evaluate the prevalence, distribution, and demographics of thoracolumbar (TL) spine injuries following blunt trauma.


METHODS
Prospective, cross-sectional study of a consecutive sample of all blunt trauma patients presenting initially to the emergency department (ED) of a Level 1 trauma center and undergoing thoracic and/or lumbar spine radiography from August 1997 to November 1998. The age, sex, and mechanism of injury of each patient as well as location and type of spine injury were recorded for those patients with vertebral fractures, dislocations, or subluxations.


RESULTS
Two thousand four hundred four blunt trauma patients were enrolled. Vertebral injuries were identified in 152 individuals (6.3%, 95% CI = 5.4% to 7.4%). Two hundred sixty distinct anatomic levels of injury were identified in these 152 individuals. Of these 260 injuries, 42 (16.2%) occurred at L1, 38 (14.6%) at L2, 29 (11.1%) at L3, and 27 (10.4%) at T12, making these the most commonly injured vertebrae. Injuries were most common (34 patients) in those aged 30-39 years and were least common (12 patients) in those under 18 years. Compression fractures (52%) were the most common injury in the thoracic spine, while transverse process fractures (48%) were the most common injuries in the lumbar spine.


CONCLUSIONS
The prevalence of TL injuries in ED blunt trauma patients undergoing TL radiographs is 6.3%. The most commonly injured area of the TL spine is the thoracolumbar junction.
Holmes
J F
JF
Division of Emergency Medicine, University of California, Davis, 95817-2282, USA. jfholmes@ucdavis.edu
Miller
P Q
PQ
Panacek
E A
EA
Lin
S
S
Horne
N S
NS
Mower
W R
WR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D017678:Sex Distribution; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging*; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000453:epidemiology*