Abdominal injuries associated with lumbar spine fractures in blunt trauma

Background: specific analysis of the relationship between abdominal injurie s and lumbar spine fractures has not yet been reported. Methods: a retrospective review of 258 blunt trauma patients with lumbar sp ine fractures treated between 1991 and 1996. Results: 26 patients sustained concomitant lumbar spine fractures and abdom inal injuries. The mechanism of injury was motor vehicle collision (73%), p edestrian-struck (11%), fall (8%) and assault (8%) resulting in ISS, RTS an d mortality of 27 +/- 4, 6.5 +/- 0.4 and 8%, respectively. Forty-four lumba r spine fractures were identified (1.7/pt) in association with splenic (54% ), renal (41%), hepatic (32%) and small bowel (23%) injuries and no retrope ritoneal involvement. Multilevel lumbar spine fractures were associated wit h a higher organ injury/fracture ratio compared with single level fractures (p < 0.01) including a twofold higher incidence of solid organ (spleen, li ver and kidney) injury (p < 0.01). The level and type of fracture did not a ffect the incidence of total and individual organ injury. Patients with abd ominal injuries were more severely injured mainly due to increased incidenc e of associated thoracic injuries although no significant difference in mor tality was observed. Conclusion: abdominal injuries occurred only in the minority of blunt traum a patients with lumbar spine fractures. These injuries, which followed a si milar distribution pattern as in blunt trauma in general, occurred most com monly due to motor vehicle collisions and in association with multilevel ve rtebral fractures. No correlation with fracture type or level was identifie d. (C) 1999 Elsevier Science Ltd. All rights reserved.