TRAUMATIC INJURIES OF THE CERVICAL SPINE: CURRENT EPIDEMIOLOGICAL PANORAMA

ABSTRACT Objective: To collect data from patients with cervical fracture who were treated surgically in a tertiary health service, in order to better understand the current scenario of this kind of injury in our population. Methods: This retrospective survey examined consecutive cases of patients with cervical spine trauma who received surgical treatment during 2013 and 2014. The data were subjected to descriptive statistical analysis. Results: Fifty-two patients were treated with surgery during 2013 and 2014. All patients classified as Frankel A and B developed respiratory failure. Patients classified as Frankel A, B, and C had significantly higher rates for postoperative complications (p < 0.01) than patients classified as Frankel D and E, except for the rate of postoperative infections (p = 0.717). Hospitalization time was also longer in the first group (p < 0.01). Conclusion: Patients with cervical trauma who present with neurological deficit at hospital admission should receive special attention, since the rate of postoperative complications is higher and hospital stays are lengthier in this group. In addition, patients with Frankel A and B classification should be monitored in an intensive care unit. Level of Evidence III; Retrospective comparative study.

摘要
目的：本研究收集三级医疗服务体系内接受手术治疗的颈椎骨折患者的临床数据，旨在深入了解我国人群中此类颈椎损伤的当前临床现状。
方法：本回顾性调查纳入2013年至2014年间连续收治的接受手术治疗的颈椎创伤患者病例，并对所采集的数据进行描述性统计分析。
结果：2013至2014年间共有52例患者接受手术治疗。所有被评定为Frankel脊髓损伤分级（Frankel）A级与B级的患者均发生呼吸衰竭。与Frankel脊髓损伤分级（Frankel）D、E级患者相比，Frankel脊髓损伤分级（Frankel）A、B、C级患者的术后并发症发生率显著更高（p<0.01），但术后感染发生率除外（p=0.717）。该组患者的住院时长亦更长（p<0.01）。
结论：因颈椎创伤入院时即存在神经功能缺损的患者需予以重点关注，此类群体的术后并发症发生率更高且住院时长更长。此外，被评定为Frankel脊髓损伤分级（Frankel）A、B级的患者应在重症监护病房（Intensive Care Unit）接受密切监护。
证据等级：Ⅲ级；回顾性对比研究。