Cervical spine injury in association with craniomaxillofacial fractures.
BACKGROUND
The incidence of cervical spine injuries associated with facial fractures varies from study to study. There is general agreement that immediate management of cervical spine injuries is mandatory to prevent further neurologic injury. Nevertheless, disagreement exists as to the actual incidence of cervical spinal trauma in conjunction with various facial fracture patterns. The purpose of this study was to review the incidence of cervical spine injury associated with various types of facial fractures presenting to St. Michael's Hospital Regional Trauma Center, Toronto, Ontario, Canada.


METHODS
The authors conducted a retrospective chart review of craniomaxillofacial fracture patients presenting to St. Michael's Hospital from January 1, 1994, to December 31, 2003, inclusive.


RESULTS
The data from this 10-year time span revealed a total of 124 patients with cervical spine injuries drawn from a cohort of 3356 patients with craniomaxillofacial fractures. The overall incidence of cervical spine injury was 3.69 percent. Of these patients, 928 had isolated upper third facial or skull fractures, whereas isolated middle third facial fractures were seen in 716 patients and isolated lower third facial fractures were present in 798 patients. Combined facial fracture patterns, involving two or more facial thirds, accounted for the greatest number of cervical spine injuries, occurring in 8.86 percent (n = 914).


CONCLUSIONS
The relationship between cervical spinal injuries and craniomaxillofacial trauma has been better defined as it relates to a regional trauma registry. The implications as related to the trauma assessment, diagnosis, and treatment of these injuries are reviewed.
Elahi
Mohammed M
MM
Toronto, Ontario, Canada From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Trauma Program, St. Michael's Hospital.
Brar
Mantaj S
MS
Ahmed
Najma
N
Howley
D Brent
DB
Nishtar
Saadia
S
Mahoney
James L
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D015897:Comorbidity; D006259:Craniocerebral Trauma / Q000453:epidemiology*; D005147:Facial Bones / Q000293:injuries; D005151:Facial Injuries / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008446:Maxillofacial Injuries / Q000453:epidemiology*; D008875:Middle Aged; D012189:Retrospective Studies; D012887:Skull Fractures / Q000453:epidemiology; D013124:Spinal Injuries / Q000453:epidemiology*; D014193:Trauma Centers / Q000706:statistics & numerical data