Characteristics and comparative study of thoracolumbar spine injury and dislocation fracture due to tertiary trauma

Purpose Thoracolumbar spine injury is frequently seen with high-energy trauma but dislocation fractures are relatively rare in spinal trauma, which is often neurologically severe and requires urgent treatment. Therefore, it is essential to understand other concomitant injuries when treating dislocation fractures. The purpose of this study is to determine the differences in clinical features between thoracolumbar spine injury without dislocation and thoracolumbar dislocation fracture. Methods We conducted an observational study using the Japan Trauma Data Bank (2004-2019). A total of 734 dislocation fractures (Type C) and 32,382 thoracolumbar spine injuries without dislocation (Non-type C) were included in the study. The patient background, injury mechanism, and major complications in both groups were compared. In addition, multivariate analysis of predictors of the diagnosis of dislocation fracture using logistic regression analysis were performed. Results Items significantly more frequent in Type C than in Non-type C were males, hypotension, bradycardia, percentage of complete paralysis, falling objects, pincer pressure, accidents during sports, and thoracic artery injury (P < 0.001); items significantly more frequent in Non-type C than in Type C were falls and traffic accidents, head injury, and pelvic trauma (P < 0.001). Logistic regression analysis showed that younger age, male, complete paralysis, bradycardia, and hypotension were associated with dislocation fracture. Conclusion Five associated factors were identified in the development of thoracolumbar dislocation fractures.

Automated summary

This study aimed to investigate the clinical differences between thoracolumbar spine injury without dislocation and thoracolumbar dislocation fractures. The study found that factors associated with dislocation fractures included male gender, hypotension, bradycardia, complete paralysis, falling objects, pincer pressure, accidents during sports, and thoracic artery injury. On the other hand, non-dislocation thoracolumbar spine injuries were significantly associated with falls and traffic accidents, head injuries, and pelvic trauma.