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


CONCLUSIONS
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.
Singh
Ranjit
R
Medical School, University of Melbourne, Melbourne, Victoria, Australia.
McD Taylor
David
D
D'Souza
Donna
D
Gorelik
Alexandra
A
Page
Patrick
P
Phal
Pramit
P
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000293:injuries; D015897:Comorbidity; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D015999:Multivariate Analysis; D012272:Ribs / Q000293:injuries; D016103:Spinal Fractures / Q000150:complications*; D013904:Thoracic Vertebrae / Q000293:injuries*; D015599:Trauma Severity Indices; D014739:Victoria