Clinical characteristics of traumatic spinal fractures in elderly

English Keywords:Spinal fracture  Spinal cord injury  Elderly  Clinical characteristics  Sex differences  Prevention

English Abstract:

  【Abstract】 Objectives: To analyze the clinical characteristics of traumatic spinal fractures in elderly and their prevention and intervention. Methods: A review of 271 cases(129 males and 142 females, aged from 60 to 89 years old, mean age 68.8 years old） suffering from spinal fractures treated in our hospital from January 2002 to December 2011 were undertaken. The distributions of age and sex, causes of fractures, fractured levels, injury severity scores, spinal cord injury according to American Spinal Injury Association(ASIA) classification and frequencies of multiple spinal fractures and associated injuries were analyzed retrospectively. Results: The 60 to 69 year-old patients formed the largest group, accounting for 60.1％(163/271). Falling was the main cause of traumatic spinal fracture, accounting for 44.6％(121/271). Frequencies of high falling and direct collision with a blunt object in male patients were significantly higher than the female(P<0.05). Frequencies of low falling in female patients were significantly higher than the male(P<0.05). There were 426 vertebral body fractures, thoracic and lumbar vertebral bodies accounting for 80.8%(344/426), in which thoracolumbar segment accounting for 53.3%(227/426). Frequencies of cervical spinal fractures, spinal cord injury, associated injury and the injury severity scores(ISS) in the male were higher than the female(P<0.05). Frequencies of thoracic and thoracolumbar spinal fractures in the female were higher than the male(P<0.05). The main cause of multiple spinal fractures was high falling in the male and low falling in the female. According to ASIA scale, the rate of spinal cord in level A, B, C and D was 7.0%(19/271), 1.8%(5/271), 4.8%(13/271) and 18.1%(49/271) respectively. Patients with level ASIA A accounted for 13.2%(17/129） in male and 0.8%(2/237) in female, and there was a significant difference（P<0.05）. Conclusions: There were significant sex differences in causes of total traumatic spinal fractures and multiple spinal fractures, fracture segments, ASIA scale and so on, we should make the prevention and treatment according to the sex differences of clinical characteristics of traumatic spinal fractures among the elderly.