Thoracic spinal fractures and aortic rupture: a significant and fatal association.

We analyzed the frequency of occurrence of traumatic aortic rupture (TAR) in patients with and without thoracic spinal fractures. Among 4,676 blunt chest trauma victims admitted to the hospital between 1972 and 1988, 148 (3.2%) suffered one or more thoracic vertebral fractures. There were 73 patients with one or more fractures of the first eight thoracic vertebrae (T1 to T8); of these 73, 4 also suffered TAR (5.5%). There were 4,603 patients without fractures of T1 to T8, and 64 of these patients also suffered TAR (1.4%). This difference was significant by the chi2 and Fisher exact tests, p = 0.00378 and p = 0.021003, respectively. Additionally, all 5 patients with TAR and thoracic vertebral fractures died. We conclude that patients with one or more fractures of T1 to T8 have a statistically significant increase in the incidence of TAR.