Fracture Status Affecting the Management of Traumatic Cervical Spinal Injury: A National Trauma Data Bank Analysis
Location
LSUHSC-NO Center for Advanced Learning and Simulation
Document Type
Presentation
Start Date
21-6-2025 10:20 AM
End Date
21-6-2025 11:15 AM
Publication Date
June 2025
Description
Introduction: Traumatic cervical spinal cord injuries (SCI) often result in a significantly impaired quality of life for those affected. Early decompression of spinal cord injuries within 24 hours has been associated with improved patient outcomes. Consequently, variations in time to emergency spinal decompression significantly impact patients’ complication rate and postoperative recovery. This study aimed to identify differences in time to surgical decompression based on fracture status. Methods: Patients who experienced a traumatic cervical SCI from 2017-2020 were extracted from The National Trauma Data Bank using ICD-9 and ICD-10 codes. Patients were propensity score matched 1:1 based on preexisting comorbidities. Outcome variables examined included age, fracture status, time to surgical decompression, and hospital complications. Patients with central cord syndrome were excluded. Results: 13,738 patients met inclusion criteria. Patients who had a cervical SCI and concomitant fracture (CF) were older compared to patients without a fracture (NCF; 62 vs 60 years, p=0.004). NCF patients experienced longer times to decompression compared to CF patients (32.3 vs. 25.6 hrs, p<0.0001). Additionally, NCF patients experienced early and ultra-early decompression at lower rates when compared to CF patients (Table 1). NCF patients spent more time in the emergency department (3.2 vs 2.2 hours, p <0.0001) but less time on the ventilator (5.0 vs 7.0 days, p<0.0001), in the hospital (9.0 vs 11.0 days, p<0.0001), and in the ICU (5.0 vs 6.0 days, p<0.0001) compared to CF patients. Discussion: Patients who experienced a cervical SCI without a concomitant fracture experienced delayed operative management at higher rates than CF patients. Future work is needed to optimize treatment algorithms and expedite surgical intervention. Significance/Clinical relevance: Reduction in spinal decompression to under 24 hours is critical in optimizing patient outcomes.
Recommended Citation
Bratton, Matthew, "Fracture Status Affecting the Management of Traumatic Cervical Spinal Injury: A National Trauma Data Bank Analysis" (2025). Dept. of Orthopaedics: Robert D. D’Ambrosia Lectureship & Research Day. 1.
https://digitalscholar.lsuhsc.edu/ortho_rd/2025/presentation2/1
Fracture Status Affecting the Management of Traumatic Cervical Spinal Injury: A National Trauma Data Bank Analysis
LSUHSC-NO Center for Advanced Learning and Simulation
Introduction: Traumatic cervical spinal cord injuries (SCI) often result in a significantly impaired quality of life for those affected. Early decompression of spinal cord injuries within 24 hours has been associated with improved patient outcomes. Consequently, variations in time to emergency spinal decompression significantly impact patients’ complication rate and postoperative recovery. This study aimed to identify differences in time to surgical decompression based on fracture status. Methods: Patients who experienced a traumatic cervical SCI from 2017-2020 were extracted from The National Trauma Data Bank using ICD-9 and ICD-10 codes. Patients were propensity score matched 1:1 based on preexisting comorbidities. Outcome variables examined included age, fracture status, time to surgical decompression, and hospital complications. Patients with central cord syndrome were excluded. Results: 13,738 patients met inclusion criteria. Patients who had a cervical SCI and concomitant fracture (CF) were older compared to patients without a fracture (NCF; 62 vs 60 years, p=0.004). NCF patients experienced longer times to decompression compared to CF patients (32.3 vs. 25.6 hrs, p<0.0001). Additionally, NCF patients experienced early and ultra-early decompression at lower rates when compared to CF patients (Table 1). NCF patients spent more time in the emergency department (3.2 vs 2.2 hours, p <0.0001) but less time on the ventilator (5.0 vs 7.0 days, p<0.0001), in the hospital (9.0 vs 11.0 days, p<0.0001), and in the ICU (5.0 vs 6.0 days, p<0.0001) compared to CF patients. Discussion: Patients who experienced a cervical SCI without a concomitant fracture experienced delayed operative management at higher rates than CF patients. Future work is needed to optimize treatment algorithms and expedite surgical intervention. Significance/Clinical relevance: Reduction in spinal decompression to under 24 hours is critical in optimizing patient outcomes.
Comments
Student and Fellow Presentation