David Sime1, Belinda Gabbe2, Susan Liew1. 1. Department of Orthopaedic Surgery, Alfred Health, Melbourne, Victoria, Australia. 2. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Spinal injury causes a significant burden on patients, families and health services. Cervical facet fractures are uncommon, and there is a paucity of functional and health-related quality-of-life data in patients who are managed non-operatively for this injury. METHODS: Victorian State Trauma Registry patients managed in a halothoracic brace for cervical facet injuries from August 2006 to June 2013 were included. Health status (12-item Short-Form health survey), function (Glasgow Outcome Scale-Extended), pain and return to work outcomes were assessed at 6, 12 and 24 months post-injury. Subgroup analysis was performed for age, sex, comorbidity, compensable status, Injury Severity Score (ISS) and education. RESULTS: Outcome data were available for 54 patients, with road trauma being the most common mechanism (69%), followed by a fall from height (18%). Overall, good 24-month function was achieved in 35% of patients, and 51% and 77% of patients reported good physical and mental health status, respectively. Ongoing moderate-severe neck pain was present in 19% of patients. Poorer function was associated with compensable status (P = 0.05), an ISS > 12 (P = 0.001) and a lower level of education (P = 0.04). Poorer physical health status was associated with age ≥50 (P = 0.05), pre-existing comorbidities, an ISS > 12 (P = 0.04) and a lower level of education (P = 0.03). CONCLUSION: Although many patients achieved good function and health status by 24 months, neck pain remains prevalent. A number of demographic factors were associated with a poorer outcome. This understanding helps to inform prognosis when managing this injury.
BACKGROUND:Spinal injury causes a significant burden on patients, families and health services. Cervical facet fractures are uncommon, and there is a paucity of functional and health-related quality-of-life data in patients who are managed non-operatively for this injury. METHODS: Victorian State Trauma Registry patients managed in a halothoracic brace for cervical facet injuries from August 2006 to June 2013 were included. Health status (12-item Short-Form health survey), function (Glasgow Outcome Scale-Extended), pain and return to work outcomes were assessed at 6, 12 and 24 months post-injury. Subgroup analysis was performed for age, sex, comorbidity, compensable status, Injury Severity Score (ISS) and education. RESULTS: Outcome data were available for 54 patients, with road trauma being the most common mechanism (69%), followed by a fall from height (18%). Overall, good 24-month function was achieved in 35% of patients, and 51% and 77% of patients reported good physical and mental health status, respectively. Ongoing moderate-severe neck pain was present in 19% of patients. Poorer function was associated with compensable status (P = 0.05), an ISS > 12 (P = 0.001) and a lower level of education (P = 0.04). Poorer physical health status was associated with age ≥50 (P = 0.05), pre-existing comorbidities, an ISS > 12 (P = 0.04) and a lower level of education (P = 0.03). CONCLUSION: Although many patients achieved good function and health status by 24 months, neck pain remains prevalent. A number of demographic factors were associated with a poorer outcome. This understanding helps to inform prognosis when managing this injury.
Authors: Juan P Cabrera; Ratko Yurac; Alfredo Guiroy; Andrei F Joaquim; Charles A Carazzo; Juan J Zamorano; Kevin P White; Marcelo Valacco Journal: Eur Spine J Date: 2021-04-11 Impact factor: 3.134
Authors: Stacey Isidro; Robert Molinari; Tochukwu Ikpeze; Cesar Hernandez; Mohamed Salah Mahmoudi; Addisu Mesfin Journal: Global Spine J Date: 2019-02-11