What Is the Epidemiology of Cervical and Thoracic Spine Fractures?

Autor:	Balmaceno-Criss M; Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA., Lou M; Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA., Zhou JJ; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Ikwuazom CP; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Andrews C; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Alam J; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Scheer RC; Department of Orthopaedic Surgery, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA., Kuharski M; Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA., Daher M; Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA., Singh M; Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA., Shah NV; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Monsef JB; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Diebo BG; Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA.; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Paulino CB; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.; NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA., Daniels AH; Department of Orthopaedic Surgery, Warren Alpert School of Medicine of Brown University, West Providence, RI, USA.
Jazyk:	angličtina
Zdroj:	Clinical orthopaedics and related research [Clin Orthop Relat Res] 2024 Dec 01; Vol. 482 (12), pp. 2222-2235. Date of Electronic Publication: 2024 Jul 16.
DOI:	10.1097/CORR.0000000000003189
Abstrakt:	Background: Vertebral fractures are associated with enduring back pain, diminished quality of life, as well as increased morbidity and mortality. Existing epidemiological data for cervical and thoracic vertebral fractures are limited by insufficiently powered studies and a failure to evaluate the mechanism of injury. Question/purpose: What are the temporal trends in incidence, patient characteristics, and injury mechanisms of cervical and thoracic vertebral fractures in the United States from 2003 to 2021? Methods: The United States National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) database collects data on all nonfatal injuries treated in US hospital emergency departments and is well suited to capture epidemiological trends in vertebral fractures. As such, the NEISS-AIP was queried from 2003 to 2021 for cervical and thoracic fractures. The initial search by upper trunk fractures yielded 156,669 injuries; 6% (9900) of injuries, with a weighted frequency of 638,999 patients, met the inclusion criteria. The mean age was 62 ± 25 years and 52% (334,746 of 638,999) of patients were females. Descriptive statistics were obtained. Segmented regression analysis, accounting for the year before or after 2019 when the NEISS sampling methodology was changed, was performed to assess yearly injury trends. Multivariable logistic regression models with age and sex as covariates were performed to predict injury location, mechanism, and disposition. Results: The incidence of cervical and thoracic fractures increased from 2.0 (95% CI 1.4 to 2.7) and 3.6 (95% CI 2.4 to 4.7) per 10,000 person-years in 2003 to 14.5 (95% CI 10.9 to 18.2) and 19.9 (95% CI 14.5 to 25.3) in 2021, respectively. Incidence rates of cervical and thoracic fractures increased for all age groups from 2003 to 2021, with peak incidence and the highest rate of change in individuals 80 years or older. Most injuries occurred at home (median 69%), which were more likely to impact older individuals (median [range] age 75 [2 to 106] years) and females (median 61% of home injuries); injuries at recreation/sports facilities impacted younger individuals (median 32 [3 to 96] years) and male patients (median 76% of sports facility injuries). Falls were the most common injury mechanism across all years, with females more likely to be impacted than males. The proportion of admissions increased from 33% in 2003 to 50% in 2021, while the proportion of treated and released patients decreased from 53% to 35% in the same period. Conclusion: This epidemiological study identified a disproportionate increase in cervical and thoracic fracture incidence rates in patients older than 50 years from 2003 to 2021. Furthermore, high hospital admission rates were also noted resulting from these fractures. These findings indicate that current osteoporosis screening guidelines may be insufficient to capture the true population at risk of osteoporotic fractures, and they highlight the need to initiate screening at an earlier age. Level of Evidence: Level III, prognostic study. Competing Interests: All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. (Copyright © 2024 by the Association of Bone and Joint Surgeons.)
Databáze:	MEDLINE
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