Abstract
Study Design: Retrospective study of consecutive patients that were struck by motor vehicles and sustained spinal injuries over a 6-year period from 1997 to 2003. Objective: To determine spinal injury patterns and associated injuries in pedestrians struck by motor vehicles. Summary of Background Data: Motor vehicle accidents involving pedestrians are associated with high morbidity and mortality rates. Methods: All injured patients admitted to Level I Trauma and Regional Spinal Cord Injury Center were reviewed retrospectively to identify those who were struck by motor vehicles and sustained injury to the spinal column. Before 2001, clearance of the thoracolumbar (TL) spine was performed by plain radiographs. Beginning in 2001, such clearance was performed by helical truncal computed tomography of the chest/abdomen/pelvis (CT/CAP) that was performed to evaluate potential visceral injuries. Results: Of the 1672 patients who were struck by motor vehicles, 135 patients (8%) were found to have spinal injuries. Cervical injuries were found in 35%, thoracic in 19%, lumbar in 37%, and sacral injuries in 27%. Associated injuries were present in 99% of the patients. By relative risk analyses, there were no regional associations between injuries of the TL spine and injuries to the chest and abdomen. Patients frequently had combinations of injuries in distant locations, presumably from a "double-impact" injury mechanism. Before initiation of the CT/CAP protocol to clear the TL spine, 7% of patients had injuries initially missed by TL radiographs. Conclusions: Spinal injuries in pedestrians struck by motor vehicles are more evenly distributed throughout the spinal column and more often coexist with injuries to remote organs compared with car occupants and motorcyclists where regional tendencies and isolated spinal injuries are more frequent. A systematic approach to both diagnosis and treatment is, therefore, necessary. Helical truncal CT, performed to evaluate visceral injury, effectively screens for TL fractures.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 281-287 |
| Number of pages | 7 |
| Journal | Journal of Spinal Disorders and Techniques |
| Volume | 21 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jun 2008 |
| Externally published | Yes |
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Keywords
- Cervical fractures
- Computed tomography screening
- Pedestrian-motor vehicle collisions
- Sacral fractures
- Spinal injuries
- Thoracolumbar fractures
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
- Orthopedics and Sports Medicine
Cite this
Spinal injuries in pedestrians struck by motor vehicles. / Vives, Michael J.; Kishan, Shyam; Asghar, Jahangir; Peng, Bo; Reiter, Mitchellh F.; Milo, Steven; Livingston, David.
In: Journal of Spinal Disorders and Techniques, Vol. 21, No. 4, 06.2008, p. 281-287.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Spinal injuries in pedestrians struck by motor vehicles
AU - Vives, Michael J.
AU - Kishan, Shyam
AU - Asghar, Jahangir
AU - Peng, Bo
AU - Reiter, Mitchellh F.
AU - Milo, Steven
AU - Livingston, David
PY - 2008/6
Y1 - 2008/6
N2 - Study Design: Retrospective study of consecutive patients that were struck by motor vehicles and sustained spinal injuries over a 6-year period from 1997 to 2003. Objective: To determine spinal injury patterns and associated injuries in pedestrians struck by motor vehicles. Summary of Background Data: Motor vehicle accidents involving pedestrians are associated with high morbidity and mortality rates. Methods: All injured patients admitted to Level I Trauma and Regional Spinal Cord Injury Center were reviewed retrospectively to identify those who were struck by motor vehicles and sustained injury to the spinal column. Before 2001, clearance of the thoracolumbar (TL) spine was performed by plain radiographs. Beginning in 2001, such clearance was performed by helical truncal computed tomography of the chest/abdomen/pelvis (CT/CAP) that was performed to evaluate potential visceral injuries. Results: Of the 1672 patients who were struck by motor vehicles, 135 patients (8%) were found to have spinal injuries. Cervical injuries were found in 35%, thoracic in 19%, lumbar in 37%, and sacral injuries in 27%. Associated injuries were present in 99% of the patients. By relative risk analyses, there were no regional associations between injuries of the TL spine and injuries to the chest and abdomen. Patients frequently had combinations of injuries in distant locations, presumably from a "double-impact" injury mechanism. Before initiation of the CT/CAP protocol to clear the TL spine, 7% of patients had injuries initially missed by TL radiographs. Conclusions: Spinal injuries in pedestrians struck by motor vehicles are more evenly distributed throughout the spinal column and more often coexist with injuries to remote organs compared with car occupants and motorcyclists where regional tendencies and isolated spinal injuries are more frequent. A systematic approach to both diagnosis and treatment is, therefore, necessary. Helical truncal CT, performed to evaluate visceral injury, effectively screens for TL fractures.
AB - Study Design: Retrospective study of consecutive patients that were struck by motor vehicles and sustained spinal injuries over a 6-year period from 1997 to 2003. Objective: To determine spinal injury patterns and associated injuries in pedestrians struck by motor vehicles. Summary of Background Data: Motor vehicle accidents involving pedestrians are associated with high morbidity and mortality rates. Methods: All injured patients admitted to Level I Trauma and Regional Spinal Cord Injury Center were reviewed retrospectively to identify those who were struck by motor vehicles and sustained injury to the spinal column. Before 2001, clearance of the thoracolumbar (TL) spine was performed by plain radiographs. Beginning in 2001, such clearance was performed by helical truncal computed tomography of the chest/abdomen/pelvis (CT/CAP) that was performed to evaluate potential visceral injuries. Results: Of the 1672 patients who were struck by motor vehicles, 135 patients (8%) were found to have spinal injuries. Cervical injuries were found in 35%, thoracic in 19%, lumbar in 37%, and sacral injuries in 27%. Associated injuries were present in 99% of the patients. By relative risk analyses, there were no regional associations between injuries of the TL spine and injuries to the chest and abdomen. Patients frequently had combinations of injuries in distant locations, presumably from a "double-impact" injury mechanism. Before initiation of the CT/CAP protocol to clear the TL spine, 7% of patients had injuries initially missed by TL radiographs. Conclusions: Spinal injuries in pedestrians struck by motor vehicles are more evenly distributed throughout the spinal column and more often coexist with injuries to remote organs compared with car occupants and motorcyclists where regional tendencies and isolated spinal injuries are more frequent. A systematic approach to both diagnosis and treatment is, therefore, necessary. Helical truncal CT, performed to evaluate visceral injury, effectively screens for TL fractures.
KW - Cervical fractures
KW - Computed tomography screening
KW - Pedestrian-motor vehicle collisions
KW - Sacral fractures
KW - Spinal injuries
KW - Thoracolumbar fractures
UR - http://www.scopus.com/inward/record.url?scp=48949100185&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=48949100185&partnerID=8YFLogxK
U2 - 10.1097/BSD.0b013e3181370703
DO - 10.1097/BSD.0b013e3181370703
M3 - Article
C2 - 18525489
AN - SCOPUS:48949100185
VL - 21
SP - 281
EP - 287
JO - Journal of Spinal Disorders
JF - Journal of Spinal Disorders
SN - 1536-0652
IS - 4
ER -