PMID: 9659474Jul 11, 1998Paper

A high risk group for thoracolumbar fractures

Injury
M J StanislasA J Stirling

Abstract

Unconscious patients with multiple injuries present a major diagnostic and therapeutic problem. The incidence of neurological deficit increases if diagnosis of a spinal injury is delayed or missed. Thoracolumbar fractures are commonly the result of high energy injuries and in an unconscious patient the risk of missing such fractures is increased considerably. There is little consensus on which blunt trauma patients warrant thoracolumbar spine films when no pain, tenderness, neurological deficit or cervical spine injuries are identified. We present a retrospective analysis of all patients who were admitted to the Major Injuries Unit at the Birmingham General Hospital and underwent radiological survey of the thoracolumbar spine. Of the 110 patients, all spinal fractures were detected in 94 patients with a Glasgow Coma Scale (GCS) > or = 11. Of the 16 with a GCS < or = 10, 9 patients had sustained injuries of their thoracolumbar spine 4 of which were not detected initially due to a decreased level of consciousness. The common features amongst the 4 patients with missed injuries were: (1) High velocity injury. (2) Decreased level of consciousness on admission. (3) Associated head injury. (4) Pelvis/lower extremity injury. We descri...Continue Reading

References

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Citations

Jan 30, 2003·The Journal of Emergency Medicine·James F HolmesWilliam R Mower
Aug 10, 2002·The Journal of Trauma·Pradeep Matthew PoonnooseMartin Raymond McClelland
Mar 15, 2006·The Journal of Trauma·Michael T ArchdeaconJohn H Wilber
Jan 12, 2008·The Journal of Trauma·Pamela W GoslarTimothy Harrington
Dec 13, 2007·The Journal of Trauma·Jose J DiazUNKNOWN EAST Practice Management Guideline Committee
Nov 13, 2008·The Journal of Trauma·Edward P JunkinsElisabeth Guenther
Nov 11, 2009·The Journal of Trauma·Martin H PouwMichael J R Edwards
Aug 24, 2012·Emergency Medicine Journal : EMJ·Dinendra Singh GillDinesh Varma
Nov 4, 2005·Journal of Neurosurgery. Spine·John P Ketz, Robert W Molinari
Sep 18, 2009·European Radiology·Monique BrinkJohan G Blickman
May 9, 2009·Emergency Medicine Australasia : EMA·Enda O'Connor, James Walsham
Nov 7, 2006·Emergency Medicine Australasia : EMA·Marten C Howes, Andrew P Pearce
Dec 27, 2012·The Journal of Trauma and Acute Care Surgery·Sherry SixtaUNKNOWN Eastern Association for the Surgery of Trauma
Jul 18, 2000·The Surgical Clinics of North America·M D Grossman, C Born
Aug 24, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·P K Karthik YelamarthySriram Rajan
Feb 3, 2005·Clinical Orthopaedics and Related Research·Dilip K Sengupta

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