VERTEBRAL ARTERY-OCCLUSION ASSOCIATED WITH CERVICAL-SPINE TRAUMA - A PROSPECTIVE ANALYSIS

Study Design. Radiographs and charts of 61 patients sustaining cervica l spine trauma were studied prospectively to determine the incidence o f vertebral artery injuries and possible correlative factors. Statisti cal analysis was conducted using chi-square testing of a two-way class ification system. Objectives. To elucidate the incidence of vertebral artery injuries associated with cervical spine trauma, and to determin e the value of various factors in predicting the existence of a verteb ral artery injury. Summary of Background Data. During a 7-month period , 61 patients (41 male patients, 20 female; average age, 40.3 years) w ith cervical spine trauma were studied. Methods. All patients admitted to the authors' hospital with cervical spine injuries underwent magne tic resonance imaging and magnetic resonance angiography of their cerv ical spine. All magnetic resonance angiographies were examined for ver tebral artery injury. Data on demographics and the injury were recorde d.Results. Complete disruption of blood flow through the vertebral art ery was demonstrated by magnetic resonance angiography in 12 of the 61 patients (19.7%). Ten of the 12 patients (83%) had either flexion dis traction or flexion compression injuries. Age, sex, mechanism of injur y, neurologic impairment, and associated injuries were not statistical ly significant in predicting the presence of a vertebral vessel occlus ion. Conclusion. The findings in this study may support the need for v ertebral Vessel evaluation in selective patients, particularly those w ith flexion injuries and with neurologic symptoms consistent with vert ebral artery insufficiency syndrome that do not correlate with the pre senting bone and soft-tissue injuries.