title: Spinal fractures in current military deployments.
abstract: OBJECTIVE
  To describe spinal fracture patterns presenting to deployed medical facilities during recent military operations.
  
  
  METHODS
  Retrospective analysis of the United Kingdom Centre for Defence Imaging Computed Tomography database, 2005-2009. Fractures are classified, mechanism noted and associated injuries recorded. Statistical analysis is by Fisher's Exact test.
  
  
  RESULTS
  128 fractures in 57 casualties are analysed. Ballistic (79%) and non-ballistic mechanisms contribute to vertebral fracture at all regions of the spinal column in patients treated at deployed medical facilities. There is a high incidence of lumbar spine fractures, which are more likely to be due to explosion than gunshot wounding (p < 0.05). Two thirds of thoracolumbar spine fractures caused by explosive devices are unstable and are mainly burst-fractures in configuration. 60% of spinal fracture patients had concomitant injuries. There is a strong relationship between spinal fractures caused by explosions and lower limb fractures.
  
  
  CONCLUSIONS
  Injuries to the spine caused by explosive devices account for greater numbers, greater associated morbidity and increasing complexity than other means of spinal injury managed in contemporary warfare. With the predominance of explosive injury in current conflict, this work provides the first detail of an evolving injury mechanism with implications for injury mitigation research.
authors.affiliation: Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham. willeardley@doctors.org.uk
authors.forename: W G P
authors.initials: WG
authors.lastname: Eardley
authors.forename: T J
authors.initials: TJ
authors.lastname: Bonner
authors.forename: I E
authors.initials: IE
authors.lastname: Gibb
authors.forename: J C
authors.initials: JC
authors.lastname: Clasper
mesh_terms: D000059:Accidents; D001753:Blast Injuries / Q000150:complications*; D002574:Cervical Vertebrae / Q000293:injuries*; D006801:Humans; D007867:Leg Bones / Q000293:injuries; D008159:Lumbar Vertebrae / Q000293:injuries*; D008889:Military Personnel; D009104:Multiple Trauma / Q000209:etiology; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology* / Q000473:pathology; D013904:Thoracic Vertebrae / Q000293:injuries*; D006113:United Kingdom; D014857:Warfare; D014948:Wounds, Gunshot / Q000150:complications*