Prevalence of cervical spine injuries in patients with facial trauma

Objective. Injuries to the spine may accompany facial trauma. By using a la rge computerized database the goal of this case control study was to assess the association between facial and cervical spine injuries among patients sustaining facial trauma. Study design. During a period of 4 years (1995 to 1998) 3083 patients, 10 y ears or older, with facial injuries were admitted to the University Hospita l of Innsbruck's Department of Oral and Maxillofacial Surgery for facial tr auma. Records were analyzed for cause of injury, age and gender distributio n, frequency and type of injury, and frequency of cervical spine injuries i n relation to facial trauma and concomitant injuries. Two hundred six (6.7% ) of these patients had experienced a concomitant cervical spine injury (ca se group). All other patients (2877) were assigned to the control group of facial trauma only. Results. Facial trauma patients with concomitant cervical spine injuries we re significantly older (mean age, 42 vs 34 years); no difference existed fo r the female/male ratio of 30:70. Sports trauma was the main cause of facia l trauma in the control group (37.4%), yet traffic accidents accounted for 43.7% of combined facial and cervical spine injuries in the case group. Cen tral mid face fractures dominated in the case group and lateral mid face fr actures in the control group. In the case group cervical spine fractures an d dislocations occurred in 19.2%. None of them showed evidence of paralysis . Concomitant brain injuries occurred in 21.6% of the case group and 8.8%, of the control group. For patients sustaining facial trauma, logistic regre ssion analysis revealed reduced risks for additional cervical spine injurie s in younger patients, female patients, absence of brain injury, and in pat ients with facial soft tissue lesions alone (58.2%) or dental trauma alone (77.5%). Conclusion. The results of this study underline the importance of proper cl inical and computed tomographic evaluation in cases of facial fractures for recognition of additional cervical spine trauma. Detection of cervical spi ne trauma can be missed, especially when pain or symptoms from other parts of the body dominate. The typical patient with concomitant neck and facial trauma is male, 40 years old, and usually involved in a traffic accident.