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Cited by 59Spinal Fractures and Fixation TechniquesTrauma and Emergency Care StudiesAutomotive and Human Injury Biomechanics

Association of injury mechanism with the risk of cervical spine fractures

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Thompson, Wendy L., Stiell, Ian G., Clement, Catherine M., Brison, Robert J., Canadian C-Spine Rule Study Group·2009·CJEM
DOI 10.1017/s1481803500010873
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Abstract

Objective: A full understanding of an injury event and the mechanical forces involved should be important for predicting specific anatomical patterns of injury. Yet, information on the mechanism of injury is often overlooked as a predictor for specific anatomical injury in clinical decision-making. We measured the relationship between mechanism of injury and risk for cervical spine fracture. Methods: Our case-control study is a secondary analysis of data collected from the Canadian C-Spine Rule (CCR) study. Data were collected from 1996 to 2002 and included patients presenting to the emergency departments of 9 tertiary care centres after sustaining acute blunt trauma to the head or neck. Cases are defined as patients who were categorized in the CCR study with a clinically important cervical spine fracture. Controls had no radiologic evidence of cervical spine injury. Bivariate and multivariate unconditional logistic regression models were used. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Among the 17 208 patients in the CCR study, 320 (2%) received a diagnosis of a cervical spine fracture. Axial loads, falls, diving incidents and nontraffic motorized vehicle collisions (e.g., collisions involving snowmobiles or all-terrain vehicles) were injury mechanisms that were significantly related to a higher risk of fracture. For motor vehicle collisions, the risk of cervical spine injury increased with the posted speed, being involved in a head-on collision or a rollover, or not wearing a seat belt (p< 0.05). The occurrence of cervical spine fracture was negligible in simple rear-end collisions (1 in 3694 cases; OR 0.015, 95% CI 0.002–0.104]). Conclusion: Our study quantitatively demonstrates the relationship between specific mechanisms of injury and the risk of a cervical spine fracture. A full understanding of the injury mechanism would assist providers of emergency health care in assessing risk for injury in trauma patients.

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  • The incidence of c-spine injuries is approximately 2% in the general trauma population.

    “the incidence of c-spine injuries is relatively low (occurring in approximately 2% in the general trauma population”

    From Airway Management in Trauma (2018) · cites this paper as [32]

    The Characteristics of study subjects section reports that 320 of 17,208 patients (2%) had a clinically important cervical spine injury. The Abstract specifies that these were patients presenting to nine tertiary-care emergency departments after acute blunt trauma to the head or neck, not the general trauma population. The 2% figure is supported, but the claimed population is broader than the study's. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The incidence of c-spine injuries is 6%-8% in patients with head and facial trauma.

    “and 6%-8% in patients with head and facial trauma)”

    From Airway Management in Trauma (2018) · cites this paper as [32]

    The Characteristics of study subjects section reports cervical spine injury in 320 of 17,208 patients (2%) enrolled after blunt head or neck trauma. Our copy does not report an incidence for patients with head and facial trauma, so it cannot verify the claimed 6%–8% for that group. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 44

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Cited by

Sorted by citations

Authors
Thompson, W. L., Stiell, I. G., Clement, C. M., Brison, R. J., & Canadian C-Spine Rule Study Group
Affiliations
  • Public Health Agency of Canada (CA)
  • University of Ottawa (CA)
  • Queen's University (CA)
Corresponding author
Brison, Robert J.
ORCID
Venue
CJEM
Publisher
Springer Science and Business Media LLC
Published
2009-01
Volume
11
Issue
01
Pages
14-22
ISSN
  • 1481-8035 (ISSN-L)
  • 1481-8043
DOI
10.1017/s1481803500010873
OpenAlex
W1594542509
Cited by
59
References
0
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 7 · 2021: 1 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 6 · 2014: 5 · 2013: 5 · 2012: 4
FWCI
3.85
Type
journal article
Language
en
Open access
Locations
  • Canadian Journal of Emergency Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
Keywords
cervical spine fractures, injury mechanisms, blunt neck trauma, Canadian C-Spine Rule, traffic accidents, falls, diving injuries, axial loading, seat belt use, head-on collisions, rollover injuries
MeSH terms
Accidental Falls, Accidents, Traffic, Adolescent, Adult, Aged, Aged, 80 and over, Cervical Vertebrae, Female, Humans, Male, Middle Aged, Wounds, Nonpenetrating, Spinal Fractures, Head Injuries, Closed, Neck Injuries, Young Adult

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