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Epidemiology of Spinal Fractures in a Level One Trauma Center in the Netherlands

A 10 Years Review

den Ouden, Lars P., MD; Smits, Arjen J., MD; Stadhouder, Agnita, MD; Feller, Ricardo, MD; Deunk, Jaap, MD, PhD; Bloemers, Frank W., MD, PhD

doi: 10.1097/BRS.0000000000002923
EPIDEMIOLOGY
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Study Design. Retrospective epidemiological study.

Objective. To describe the epidemiology of spinal fractures over a 10 years period in a level one trauma center in the Netherlands.

Summary of Background Data. Spinal fractures may have large socioeconomic consequences. The prevalence and outcomes likely change over the years owing to improved traffic safety, increasing population age and improved medical treatment. This is the first study to address the epidemiology of spinal fractures over a large period in the Netherlands.

Methods. All patients with a cervical, thoracic, or lumbar spine fracture admitted to a level one trauma center from 2007 to 2016 were prospective registered and retrospectively analyzed. In addition to patient, accident, and associated injury characteristics, radiological and surgery data were obtained from the hospital's Electronic Patient File system.

Results. Between 2007 and 2016, 1479 patients with a total of 3029 spinal fractures were admitted. Approximately 40.8% were female and 59.2% were male, with a mean age of 52.0 years; 4.9% of fractures occurred at a juvenile age (0–18 years) and 63.6% at the age of 19 to 64 years. Most fractures occurred in the thoracic spine, followed by the lumbar and cervical spine. The most common cause of injury was a fall from height, followed by traffic accidents. Spinal cord injury occurred in 8.5% and associated injuries were reported in 73% of the patients. Sixteen percent of the admitted patients were treated operatively. Over time, there was a larger increase in amount of spine fractures in elderly (≥ 65 years) compared with younger people.

Conclusion. The total amount of spine fractures per year increased over time. In addition, there was a larger increase in amount of spine fractures in patients over 65 years of age compared with younger patients. Despite this increase, a considerable amount of spine fractures still occur in the age-group of 19 to 64 years. Most fractures were located in the thoracic spine. This study might stimulate development of policy on precautionary actions to prevent spine fractures.

Level of Evidence: 4

A retrospective epidemiological study of patients that presented with a spinal fracture between 2007 and 2016 in a level one trauma center in the Netherlands with spine injury expertise. This study provides insight into the patients and fracture characteristics of spinal fractures.

Department of Trauma surgery, VU University Medical Center, Amsterdam, the Netherlands

Department of Orthopedic surgery, VU University Medical Center, Amsterdam, the Netherlands

Department of Neurosurgery, VU University Medical Center, Amsterdam, the Netherlands.

Address correspondence and reprint requests to Arjen J. Smits, MD, Department of Trauma surgery, VU University Medical Center, De Boelelaan 1117, room 7F020, 1081 HV Amsterdam, the Netherlands; E-mail: aj.smits@vumc.nl

Received 29 June, 2018

Revised 3 October, 2018

Accepted 17 October, 2018

LPDO and AJS contributed equally to this work.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

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