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Traumatic Injury of the Spine

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Surgery

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Abstract

Acute injury to the spine is a major cause of morbidity in trauma patients. Of 39.15 million reported injury-related emergency department visits in 2002, 5.1% (1.997 million) were related to the spine.1 The incidence of traumatic spinal cord injury (SCI) alone is estimated to be 11,000 to 14,000 cases per year in the United States, with an estimated annual cost of medical and supportive care exceeding $9.7 billion.2–7 SCI are particularly debilitating; more than 50% of patients with SCI are between 16 and 30 years old.2 In the acute trauma setting, SCI may be missed if appropriate clinical and radiographic tests are not performed. For example, in a 10-year retrospective study, Poonnoose et al. found that among 569 patients with SCI, 9.1% of the diagnoses were missed initially; in 50% of missed cases, mismanagement resulted in worsened neurological status.8,9 The medical and fiscal costs of caring for spine injuries are high, and spinal pathology, especially if undiagnosed, may complicate the prognosis and treatment of the trauma patient. Outcome depends highly on appropriate management, skilled surgical intervention, and management of comorbid conditions. As such, it is important to approach the patient with a potential traumatic injury of the spine with an accurate understanding of potential pathology and stability, to manage the patient appropriately.

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Authors and Affiliations

  1. Department of Neurological Surgery, New York-Presbyterian Hospital, New York, NY, USA

    Justin F. Fraser MD (Resident)

  2. Departments of Neurological Surgery, and Surgery, Weill Cornell Medical College, New York, NY, USA

    John Boockvar MD (Alvina and Willis Murphy Assistant Professor)

  3. Neurological Surgery, Weill Cornell Medical College, New York, NY, USA

    Roger Hartl MD (Assistant Professor)

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  1. Justin F. Fraser MD
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  2. John Boockvar MD
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  3. Roger Hartl MD
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Editor information

Editors and Affiliations

  1. Department of Surgery, Stanford University Medical Center, Stanford, CA, USA

    Jeffrey A. Norton MD, FACS (Robert L. and Mary Ellenburg Professor, Chief) (Robert L. and Mary Ellenburg Professor, Chief)

  2. Divisions of Surgical Oncology and General Surgery, Department of Surgery, Stanford University Medical Center, Stanford, CA, USA

    Jeffrey A. Norton MD, FACS (Robert L. and Mary Ellenburg Professor, Chief) (Robert L. and Mary Ellenburg Professor, Chief)

  3. Departments of Surgery and Public Health, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, USA

    Philip S. Barie MD, MBA, FCCM, FACS (Professor, Chief) (Professor, Chief)

  4. Division of Critical Care and Trauma, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, USA

    Philip S. Barie MD, MBA, FCCM, FACS (Professor, Chief) (Professor, Chief)

  5. Departments of Surgery and Immunology, Duke University Medical Center, Durham, NC, USA

    R. Randal Bollinger MD, PhD, FACS (Professor) (Professor)

  6. Division of Surgical Oncology, Department of Surgery, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI, USA

    Alfred E. Chang MD, FACS (Chief, Hugh Cabot Professor of Surgery) (Chief, Hugh Cabot Professor of Surgery)

  7. Department of Surgery, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA

    Stephen F. Lowry MD, MBA, FACS (Professor and Chairman) (Professor and Chairman)

  8. Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Stephen F. Lowry MD, MBA, FACS (Professor and Chairman) (Professor and Chairman)

  9. Department of Surgery, The University of Utah, Salt Lake City, UT, USA

    Sean J. Mulvihill MD, FACS (Professor and Chair, Senior Director of Clinical Affairs) (Professor and Chair, Senior Director of Clinical Affairs)

  10. Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA

    Sean J. Mulvihill MD, FACS (Professor and Chair, Senior Director of Clinical Affairs) (Professor and Chair, Senior Director of Clinical Affairs)

  11. Departments of Cardiothoracic Surgery and Surgery, New York University Medical Center, New York, NY, USA

    Harvey I. Pass MD, FACS (Professor) (Professor)

  12. Radiology, and Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO, USA

    Robert W. Thompson MD, FACS (Professor of Surgery (Section of Vascular Surgery), Vice-Chairman for Research) (Professor of Surgery (Section of Vascular Surgery), Vice-Chairman for Research)

  13. Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Robert W. Thompson MD, FACS (Professor of Surgery (Section of Vascular Surgery), Vice-Chairman for Research) (Professor of Surgery (Section of Vascular Surgery), Vice-Chairman for Research)

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Fraser, J.F., Boockvar, J., Hartl, R. (2008). Traumatic Injury of the Spine. In: Norton, J.A., et al. Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68113-9_30

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