Traumatic Death due to Simultaneous Double Spine Fractures in Patient with Ankylosing Spondylitis

The aim of this study is to report the rare occurrence of simultaneous double spine fractures in a patient with progressive ankylosing spondylitis (AS). An 82-year-old male with established AS had low-energy falls. He had sustained simultaneous double spine fractures and died. Plain radiographs of the cervical spine were unremarkable in detecting a cervical spine fracture in a patient with AS and a spinal cord injury following a fall. CT scan showed a displaced fracture at the C6/C7 with American Spinal Injury Association-A spinal cord injury and displaced fracture at L1. The cause of death was determined to be upper spinal cord injury caused by cervical spinal fracture and dislocation that were facilitated by spinal rigidity from AS. This case report illustrates the importance of obtaining a detailed medical history and thorough imaging study when investigating deaths, including nonfatal conditions, such as AS. Furthermore, it shows the value of entire spine CT scan in the evaluation of the mechanism, further spine fractures, and manner of death. Despite the occurrence of spine fracture in AS patients, simultaneous double or multiple spine fractures are extremely rare and can be missed. Care should be taken for the further spine fracture in the entire spine in patient with AS.

Download Full-text

The safety of orotracheal intubation in patients with unstable cervical spine fracture or high spinal cord injury

The American Journal of Surgery ◽

10.1016/s0002-9610(99)80040-3 ◽

1995 ◽

Vol 170 (6) ◽

pp. 676-680 ◽

Cited By ~ 68

Author(s):

Clayton H. Shatney ◽

Richard D. Brunner ◽

Tai Q. Nguyen

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spine ◽

Orotracheal Intubation ◽

Spine Fracture ◽

Cervical Spine Fracture ◽

Cord Injury ◽

Unstable Cervical Spine

Download Full-text

Traumatic cervical spinal cord injury with "negative" cervical spine CT scan

BMJ Case Reports ◽

10.1136/bcr.12.2009.2525 ◽

2010 ◽

Vol 2010 (mar04 1) ◽

pp. bcr1220092525-bcr1220092525 ◽

Cited By ~ 1

Author(s):

S. Kolli ◽

A. Schreiber ◽

J. Harrop ◽

J. Jallo

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spine ◽

Ct Scan ◽

Cervical Spinal Cord ◽

Cervical Spinal Cord Injury ◽

Spine Ct ◽

Cord Injury

Download Full-text

Progression of local kyphosis after conservative treatment for compressive cervical spine fracture with spinal cord injury

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1115-z ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Kazuya Yokota ◽

Takeshi Maeda ◽

Osamu Kawano ◽

Eiji Mori ◽

Tsuneaki Takao ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spine ◽

Conservative Treatment ◽

Spine Fracture ◽

Cervical Spine Fracture ◽

Cord Injury ◽

Local Kyphosis

Download Full-text

Health care burden of cervical spine fractures in the United States: analysis of a nationwide database over a 10-year period

Journal of Neurosurgery Spine ◽

10.3171/2010.3.spine09530 ◽

2010 ◽

Vol 13 (1) ◽

pp. 61-66 ◽

Cited By ~ 32

Author(s):

Ali A. Baaj ◽

Juan S. Uribe ◽

Tann A. Nichols ◽

Nicholas Theodore ◽

Neil R. Crawford ◽

...

Keyword(s):

Health Care ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spine ◽

Adverse Outcomes ◽

Spine Fractures ◽

Cord Injury ◽

The Us ◽

Discharge Status ◽

Cervical Spine Fractures

Object The objective of this work was to search a national health care database of patients diagnosed with cervical spine fractures in the US to analyze discharge, demographic, and hospital charge trends over a 10-year period. Methods Clinical data were derived from the Nationwide Inpatient Sample (NIS) for the years 1997 through 2006. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. Patients with cervical spine fractures with and without spinal cord injury (SCI) were identified using the appropriate ICD-9-CM codes. The volume of discharges, length of stay (LOS), hospital charges, total national charges, discharge pattern, age, and sex were analyzed. National estimates were calculated using the HCUPnet tool. Results Approximately 200,000 hospitalizations were identified. In the non-SCI group, there was a 74% increase in hospitalizations and charges between 1997 and 2006, but LOS changed minimally. There was no appreciable change in the rate of in-hospital mortality (< 3%), but discharges home with home health care and to skilled rehabilitation or nursing facilities increased slightly. In the SCI group, hospitalizations and charges increased by 29 and 38%, respectively. There were no significant changes in LOS or discharge status in this group. Spinal cord injury was associated with increases in LOS, charges, and adverse outcomes compared with fractures without SCI. Total national charges associated with both groups combined exceeded $1.3 billion US in 2006. Conclusions During the studied period, increases in hospitalizations and charges were observed in both the SCI and non-SCI groups. The percentage increase was higher in the non-SCI group. Although SCI was associated with higher adverse outcomes, there were no significant improvements in immediate discharge status in either group during the 10 years analyzed.

Download Full-text