FAILS AND MAJOR INJURIES ARE DISH FACTORS FOR THORACOLUMBAR FRACTURES- COGNITIVE IMPAIRMENT AND MULTIPLE INJURIES IMPEDE THE DETECTION OF BACK PAIN AND TENDERNESS

Risk factors for thoracolumbar fracture (TLF) and occurrence of back p ain/tenderness detection (BPTD) in TLF patients have not been fully ev aluated, Of 4142 blunt trauma patients directly admitted to a level I trauma center, 183 (4.4%) had a TLF. Risk factors for TLF (p less than or equal to 0.05) were major non-TLF injuries (Abbreviated Injury Sca le score greater than or equal to 3) and a fall mechanism of injury. O f 110 with TLF, Glasgow Coma Scale score (GCS) of 13 to 15, and no mye lopathy, 34 (30.9%) had no BPTD; 7 of 34 (20.6%) required operative sp inal stabilization. BPTD was lacking in 63% of patients with GCS score s of 13 to 14 compared to 22% of patients with GCS scores of 15 (p = 0 .001). BPTD was decreased when major non-TLF injuries were present (63 vs. 91%) in the GCS score of 15 group (0.003), but similar in GCS sco re of 13 to 14 patients. In patients with GCS scores of 13 to 15, decr eased BPTD is simultaneously related to both cognitive dysfunction and major injuries (p = 0.005). In conclusion, major injuries and falls a re risks for TLF and cognitive deficit and major injury impedes BPTD i n TLF. Thoracolumbar x-ray films should be carefully considered in pat ients with altered mentation or major injury.