Alterations of the biomarker S-100B and NSE in patients with acute vertebral spine fractures.
BACKGROUND
Although several publications concerning the use of the biomarkers S100B and neuron-specific enolase (NSE) in vertebral spine fractures in animal experimental studies have proven their usefulness as early indicators of injury severity, there are no clinical reports on their effectiveness as indicators in patients with spinal injuries. As these biomarkers have been examined, with promising results, in patients with traumatic brain injury, there is a potential for their implementation in patients with vertebral spine fractures.


OBJECTIVE
To investigate the early serum measurement of S100B and NSE in patients with vertebral spine fractures compared with those in patients with acute fractures of the proximal femur.


METHODS
Prospective longitudinal cohort study.


METHODS
A cohort of 34 patients admitted over an 18-month period to a single medical center for suspected vertebral spine trauma. Twenty-nine patients were included in the control group.


METHODS
S100B and NSE serum levels were assessed in different types of vertebral spine fractures.


METHODS
We included patients older than 16 years with vertebral spine fractures whose injuries were sustained within 24 hours before admission to the emergency room and who had undergone a brief neurologic examination. Spinal cord injuries (SCIs) were classified as being paresthesias, incomplete paraplegias, or complete paraplegias. Blood serum was obtained from all patients within 24 hours after the time of injury. Serum levels of S100B and NSE were statistically analyzed using Wilcoxon signed-rank test.


RESULTS
S100B serum levels were significantly higher in patients with vertebral spine fractures (p=.01). In these patients, the mean S100B serum level was 0.75 μg/L (standard deviation [SD] 1.44, 95% confidence interval [CI] 0.24, 1.25). The mean S100B serum level in control group patients was 0.14 μg/L (SD 0.11, 95% CI 0.10, 0.19). The 10 patients with neurologic deficits had significantly higher S100B serum levels compared with the patients with vertebral fractures but without neurologic deficits (p=.02). The mean S100B serum level in these patients was 1.18 μg/L (SD 1.96). In the 26 patients with vertebral spine fractures but without neurologic injury, the mean S100B serum level was 0.42 μg/L (SD 0.91, 95% CI 0.08, 0.76). The analysis revealed no significant difference in NSE levels.


CONCLUSIONS
We observed a significant correlation not only between S100B serum levels and vertebral spine fractures but also between S100B serum levels and SCIs with neurologic deficit. These results may be meaningful in clinical practice and to future studies.
Department of Trauma Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: harald.wolf@meduniwien.ac.at.
Harald
H
Wolf
Department of Medical Statistics, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
Christoph
C
Krall
Department of Trauma Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Gholam
G
Pajenda
Department of Trauma Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Johannes
J
Leitgeb
Department of Anaesthesia and Intensive Care Medicine, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Adam J
AJ
Bukaty
Department of Trauma Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Stefan
S
Hajdu
Department of Trauma Surgery, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Kambiz
K
Sarahrudi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005264:Femoral Fractures / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D009418:S100 Proteins / Q000097:blood*; D016103:Spinal Fractures / Q000097:blood*
D015415:Biomarkers; D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase
Biomarker; NSE; Neurologic deficit; S100B; Spinal cord injury; Spinal trauma; Vertebral spine fractures