Isolated Transverse Process Fractures and Markers of Associated Injuries: The Experience at University of California, Los Angeles.

Autor: Bui TT; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Nagasawa DT; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Lagman C; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Jacky Chen CH; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Chung LK; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Voth BL; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Beckett JS; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Tucker AM; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Niu T; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Gaonkar B; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Yang I; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA., Macyszyn L; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA; UCLA Comprehensive Spine Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. Electronic address: lmacyszyn@mednet.ucla.edu.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2017 Aug; Vol. 104, pp. 82-88. Date of Electronic Publication: 2017 Apr 28.
DOI: 10.1016/j.wneu.2017.04.137
Abstrakt: Objectives: To report a single-institution experience with isolated transverse process fractures (ITPFs) and provide increasing support for the development of evidence-based guidelines. The authors also evaluated the presence of concerning symptoms or red flags that may indicate additional, underlying injuries in the setting of ITPFs.
Methods: The Ronald Reagan UCLA Medical Center patient database was queried (years 2005-2016) using International Classification of Diseases, Ninth Revision, code 805: fracture of the vertebral column without mention of spinal cord injury.
Results: A total of 129 patients with ITPFs were identified. Mean age was 38.1 years (range 15-92 years). Women were more likely to present with abdominal pain and associated kidney injury (P = 0.018 and P = 0.012, respectively). Motor vehicle accident (MVA) was the most common mechanism of injury (n = 81, 62.8%) and was associated with thoracic (P = 0.032) and lower extremity pain/injury (P = 0.005). Back pain was the most common presenting symptom (n = 71, 64.6%) and was associated with intraabdominal and lower extremity injuries (P = 0.032 and P = 0.016, respectively). Chest and neck pain were associated with vascular injuries (P < 0.001 and P = 0.001, respectively). Spine consult (neurosurgery or orthopedic surgery) was frequent (n = 94, 72.9%) and was more common after MVA versus fall (P = 0.018).
Conclusions: Several factors were identified as significant markers of associated injuries, including female sex, MVA, and presenting symptoms. Neck and chest pain were significantly associated with vascular injuries. Clinicians should maintain high indices of suspicion for associated injuries in patients with ITPFs, especially after high-velocity mechanisms.
(Copyright © 2017. Published by Elsevier Inc.)
Databáze: MEDLINE
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