Explosions are the main cause of spine injuries to wounded military personnel
Spinal injuries are among the most disabling conditions affecting wounded members of the U.S. military. Yet until recently, the nature of those injuries had not been adequately explored.
In a new study recently published in the Journal of Bone and Joint Surgery (JBJS), a team of orthopaedic surgeons reviewed more than eight years of data on back, spinal column, and spinal cord injuries sustained by American military personnel while serving in Iraq or Afghanistan. The injuries were then categorized according to anatomic location, neurological involvement, the cause of the injury, and accompanying wounds.
The resulting analysis is an important first step in helping orthopaedic surgeons develop treatment plans for these service members, as well as for severely injured civilians who sustain similar disabling injuries.
Key Findings:
Of 10,979 evacuated combat casualties, 598 (5.45 percent) sustained a total of 2,101 spinal injuries.
Explosions accounted for 56 percent of spine injuries, motor vehicle collisions for 29 percent, and gunshots for 15 percent.
92 percent of all injuries were fractures.
The average age at the time of injury was 26.5 years of age.
90 percent of the injured were enlisted personnel.
84 percent of patients sustained their wounds as a result of combat.
In 17 percent of injuries to the spine, the spinal cord also was injured.
53 percent of all gunshot wounds to the spine resulted in a spinal cord injury.
Spinal injuries were frequently accompanied by injuries to the abdomen, chest, head, and face.
“In these current military conflicts, the latest technologies in body armor, helmets, and other protective devices have helped save many soldiers’ lives,” says James A. Blair, MD, an orthopaedic surgery chief resident in the Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX. “We also have access to advanced life-saving techniques in the field and medical evacuation strategies that are keeping many more service members alive.
Spinal cord injury can happen to anyone at anytime and it’s not just about being in a wheelchair – but about lack of control, independence and freedom.
The spinal cord consists of a complex bundle of nerves running from the brain to the base of the spine.
This acts as a telecommunications system between the brain and the body, thereby enabling the body to function properly.
Main Causes:
More than one injury of this type occurs every day in Australia.
Motoring accidents (53% of SCI is through motor accidents)
Sporting accidents 12% (rugby, horseriding, diving, skiing, etc)
Everyday accidents 23% (falls from ladders, slipping and falling onto hard surfaces, work place accidents, etc)
There are approximately 15,000 men and women living with paralysis caused by spinal injury in Australia.
Global Summary:
SCI is a global epidemic
Annually, 20 people in 1 million of population suffer SCI
Average age of SCI sufferer is 33 years
Highest incidences of injuries occur at the age of 19!
A rough extrapolation suggests between 4 and 5 million of the total world population live with SCI
“But when a person survives an explosion or vehicle collision, there has still been a great deal of force on the body,” Blair adds. “Many of those survivors are coming to us with severe injuries to their spine and back. We needed to describe and characterize these injuries so recommendations can be made on how to provide the most effective treatment and rehabilitation for our wounded warriors.”
Although the survival rate is high for such injuries, the disability rate also is quite high. This affects not only the service members, but also their families and the U.S. healthcare system. Therefore, the study’s authors note, further research is required to improve future outcomes for those with spinal injuries.
Non-traumatic injuries
Some spinal cord injuries are non-traumatic, in which the damage is slower-acting and cumulative, but the end result is the same. SCI can result from arthritis, cancer, other tumors, blood vessel problems or bleeding, spinal inflammation or infections. Degenerative disease of the intervertebral discs, the pads of tissue that separate and cushion the vertebrae can also cause pressure on the spinal cord severe enough to cause injury.
Who is at risk for SCI?
Although an unexpected trauma like a motor vehicle collision can happen to anyone, the numbers for SCI are skewed toward men. About 80% of spinal cord injury victims are men. The age group most at risk is young adults, ages 16-30. Participation in the high risk sports named above increases risk.
The other group at risk is people over 65, for whom falls are the most frequent cause of spinal injury. People with predisposing conditions such as arthritis and osteoporosis can develop a spinal column injury from a relatively minor injury.
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September 19th Full JBJS Table of Contents
The Efficacy of Intraarticular Injections for Pain Management Following the Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures: A Randomized Controlled Trial
Realiability and Validity of Diagnosing Acetabular Labral Lesions Using Magnetic Resonance Arthrography
Prospective, Observational Study of Donor Site Morbidity Following Anterior Illiac Crest Bone Grafting in Orthopaedic Trauma Reconstruction Patients
Corrosion at the Head-Neck Taper as a Cause for Adverse Local Tissue Reactions in Total Hip Arthroplasty
Quantification of Humeral Head Deformity Following Newnatal Brachial Plexus Palsy
Sclerostin Antibody Increases Bone Volume and Enhances Implant Fixation in a Rat Model
Cementless Total Hip Arthroplasty with the Rectangular Titanium Zweymuller Stem. A Concise Follow-up, at a Minimum of Twenty Years, of a Previous Report
The Effect of Iliac Crest Autograft on the Outcome of a Fusion in the Setting of Degenerative Spondyloisthesis? A subgroup analysis of the SPORT study
Variability in Costs Associated with Total Hip and Knee Replacement Implants
A Nation in Motion
More than one in four Americans have bone or joint health problems, making them the greatest cause of lost work days in the U.S. When orthopaedic surgeons restore mobility and reduce pain, they help people get back to work and to independent, productive lives. Orthopaedic surgeons provide the best value in American medicine in both human and economic terms and access to high-quality orthopaedic care keeps this “Nation in Motion.”