Incidence of Traumatic Spinal Fractures in the Netherlands: Analysis of a Nationwide Database.

STUDY

DESIGN

Retrospective database study based on prospectively collected data.

OBJECTIVE

The aim of this study was to describe the current incidence and epidemiology of traumatic spinal fractures in the Netherlands SUMMARY OF BACKGROUND DATA.: Traumatic spinal fractures may lead to severe disability and have considerable consequences on healthcare capacity and costs. Several studies have reported a large and increasing share of fractures in elderly. Currently, a reliable, detailed, and up to date incidence of these injuries in the Netherlands is lacking. These numbers could aid in the composition of preventative measures.

METHODS

All patients from 2010 to 2017 that were admitted with a spinal fracture were included. Patients were selected based on Abbreviated Injury Scores (AIS) codes. Collected data consisted of patient- and injury characteristics, afflicted spine-region, associated injury, referral- and discharge location, and geographic region of admittance.

RESULTS

Overall, 29,637 patients were included in this study. The incidence of spinal fractures increased from 2010 to 2017 (from 21.5 to 24.0 per 100,000 inhabitants). Most patients were injured by a (low-energy) fall from the same level followed by (high-energy) traffic accidents. Elderly patients (≥65 years of age) made up 42% of all patients. The proportion of elderly increased significantly faster over the years compared to younger patients. More than half of polytrauma (injury severity score ≥16) patients had fractures in multiple spine regions. 5,5% of all patients suffered spinal cord injury (SCI), most often associated with cervical fractures in polytrauma patients. Regional differences were found mainly in presentation through referral and low- and high-energy falls.

CONCLUSION

The incidence of patients with spinal fractures increased and elderly made up a large part. Preventative measures could be regional dependent and should focus on low-energy falls, traffic accidents, and bicycle accidents in specific. In polytraumatized patients there should be special attention for any additional spine fractures and SCI.

LEVEL OF EVIDENCE: 3.