NYMC Faculty Publications
Post-Traumatic Cervical Spine Epidural Hematoma: Incidence and Risk Factors
DOI
10.1016/j.injury.2017.08.060
Journal Title
Injury
First Page
2529
Last Page
2533
Document Type
Article
Publication Date
11-1-2017
Department
Orthopedic Surgery
Second Department
Physical Therapy
Abstract
BACKGROUND: The incidence and risk factors for post-traumatic cervical epidural hematoma are not well described in the current literature. Our aim was to determine the incidence and associated risk factors for post-traumatic cervical spine epidural hematoma (SEH).
METHODS: We performed a retrospective review of our institution's prospectively collected data submitted to the state trauma registry, using ICD-9 codes, for all patients activated as a trauma with cervical spine injuries, between the years 2010 and 2014. Patients with MRI available were classified based on the presence of cervical epidural hematoma (CEH) or no hematoma (NEH). For our second analysis, we classified patients with cord compression associated with an epidural hematoma (CC) and no cord compression (NCC). Potential risk factors evaluated included: INR, PTT, albumin and platelets levels, radiographic findings of Ankylosing Spondylitis (AS), and ISS. No conflicts of interest exist and/or funding was used for this study.
RESULTS: 497 out of 1810 trauma activations met our inclusion criteria. 46 patients (2.5%) were found to have a post-traumatic cervical SEH (CEH). Of the CEH cohort, 76% were male, with 72% Caucasian, and a mean age of 55 years. 27 patients (5.4%) were found to have cervical cord compression at the level of the SEH. Of the CC arm, 78% were male, with 67% Caucasian, and a mean age of 56 years. A higher ISS and an elevated INR were found to be associated with epidural hematoma causing cord compression.
CONCLUSIONS: An incidence of 2.5% is reported for post-traumatic cervical spine epidural hematoma. Of these, 59% had associated spinal cord compression. Patients with a higher ISS and elevated INR levels are at a higher risk for developing this potentially devastating.
Recommended Citation
Ricart, P., Verma, R., Fineberg, S., Fink, K., Lucas, P. A., Lo, Y., Asprinio, D. E., & Amorosa, L. (2017). Post-Traumatic Cervical Spine Epidural Hematoma: Incidence and Risk Factors. Injury, 48 (11), 2529-2533. https://doi.org/10.1016/j.injury.2017.08.060
Publisher's Statement
The original material can be found here: https://doi.org/10.1016/j.injury.2017.08.060