title: Non-spinal-associated injuries with lumbar transverse process fractures: influence of segments, amount, and concomitant vertebral fractures.
abstract: BACKGROUND
  Lumbar transverse process fractures (LTPFs) are often with concomitant non-spinal-associated injuries (NSAIs). The purpose of this study was to analyze the correlation between the NSAIs and the LTPFs of different segments, amount, and concomitant thoracolumbar/lumbar vertebral fractures.
  
  
  METHODS
  A total of 1,181 patients with LTPFs or thoracolumbar/lumbar vertebral fractures were chosen between September 2006 and June 2010. The patients were divided into three groups: thoracolumbar/lumbar vertebral fractures without LTPFs, with associated LTPFs, and isolated LTPFs (iLTPFs). The correlation of the NSAIs of different sites and the LTPFs of different segments, amount, and concomitant thoracolumbar/lumbar vertebral fractures were analyzed between and within groups by χ test and logistic regression analysis.
  
  
  RESULTS
  The incidence of NSAIs with iLTPFs and aLTFP groups were significantly higher than that of vertebral fractures without LTPF group (55.73% and 64.49% vs. 21.32%, respectively, p = 0.000). However, the incidence was not significantly different between the iLTPFs and the aLTFP groups (p = 0.106). The results with NSAIs of different sites were almost the same. L5TPFs were a stronger risk factor to NSAIs (relative risk [RR] = 15.72; 95% confidence interval [CI], 4.47-55.37; p = 0.000) in the iLTPF group (RR = 21.92; 95% CI, 6.68-71.92; p = 0.000) and in the vertebral fractures with associated LTPF group (RR = 9.42; 95% CI, 1.19-74.72; p = 0.034). L5TPFs were also a very important risk factor for pelvic injuries (RR = 46.10; 95% CI, 22.40-94.88; p = 0.000); 65.1% in L5iTPFs were accompanied with Tile-C pelvic injuries, slightly higher than in L5aTPFs (46.7%). L4TPFs were a risk factor to abdominal injuries within iLTPFs (RR = 2.27; 95% CI, 1.23-4.20; p = 0.009).
  
  
  CONCLUSIONS
  The incidence of NSAIs is very high in cases with LTPFs, particularly with L5TPFs. A detailed investigation should be performed to search for NSAIs once LTPFs are identified so that appropriate treatment can be initiated.
  
  
  METHODS
  Level III.
authors.affiliation: Department of Orthopaedics, Shanghai First People's Hospital, Shanghai, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Xia
authors.forename: Ji-Wei
authors.initials: JW
authors.lastname: Tian
authors.forename: Shuang-Hai
authors.initials: SH
authors.lastname: Dong
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Zhao
mesh_terms: D000007:Abdominal Injuries / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D013904:Thoracic Vertebrae / Q000293:injuries*; D055815:Young Adult