title: The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway.
abstract: OBJECTIVE
  The aim of this study was to estimate the incidence of traumatic cervical spine fractures (CS-fx) in a general population.
  
  
  BACKGROUND
  The incidence of CS-fx in the general population is largely unknown.
  
  
  METHODS
  All CS-fx (C0/C1 to C7/Th1) patients diagnosed with cervical-CT in Southeast Norway (2.7 million inhabitants) during the time period from April 27, 2010-April 26, 2011 were prospectively registered in this observational cohort study.
  
  
  RESULTS
  Over a one-year period, 319 patients with CS-fx at one or more levels were registered, constituting an estimated incidence of 11.8/100,000/year. The median age of the patients was 56 years (range 4-101 years), and 68% were males. The relative incidence of CS-fx increased significantly with age. The trauma mechanisms were falls in 60%, motorized vehicle accidents in 21%, bicycling in 8%, diving in 4% and others in 7% of patients. Neurological status was normal in 79%, 5% had a radiculopathy, 8% had an incomplete spinal cord injury (SCI), 2% had a complete SCI, and neurological function could not be determined in 6%. The mortality rates after 1 and 3 months were 7 and 9%, respectively. Among 319 patients, 26.6% were treated with open surgery, 68.7% were treated with external immobilization with a stiff collar and 4.7% were considered stable and not in need of any specific treatment. The estimated incidence of surgically treated CS-fx in our population was 3.1/100,000/year.
  
  
  CONCLUSIONS
  This study estimates the incidence of traumatic CS-fx in a general Norwegian population to be 11.8/100,000/year. A male predominance was observed and the incidence increased with increasing age. Falls were the most common trauma mechanism, and SCI was observed in 10%. The 1- and 3-month mortality rates were 7 and 9%, respectively. The incidence of open surgery for the fixation of CS-fx in this population was 3.1/100,000/year.
  
  
  METHODS
  This is a prospective observational cohort study and level II-2 according to US Preventive Services Task Force.
authors.affiliation: Department of Neurosurgery, Oslo University Hospital-Ullevål, Oslo, Norway. UXEGFR@ous-hf.no
authors.forename: Hege Linnerud
authors.initials: HL
authors.lastname: Fredø
authors.forename: Syed Ali Mujtaba
authors.initials: SA
authors.lastname: Rizvi
authors.forename: Bjarne
authors.initials: B
authors.lastname: Lied
authors.forename: Pål
authors.initials: P
authors.lastname: Rønning
authors.forename: Eirik
authors.initials: E
authors.lastname: Helseth
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001642:Bicycling / Q000293:injuries; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D016103:Spinal Fractures / Q000453:epidemiology*; D013167:Spondylitis, Ankylosing / Q000453:epidemiology; D055815:Young Adult