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Spinal fractures in blunt chest trauma
J H Woodring1, C Lee, K Jenkins
1Department of Diagnostic Radiology, Albert B. Chandler Medical Center, University of Kentucky, Lexington 40536-0084.
The Journal of Trauma
|June 1, 1988
Summary
Mediastinal hemorrhage after blunt chest trauma can indicate spinal injury, even in patients without neurological deficits. Early identification via chest X-ray is crucial for preventing spinal cord injury.
Area of Science:
- Traumatology
- Radiology
- Spinal Surgery
Background:
- Mediastinal hemorrhage is a known complication of blunt chest trauma.
- Spinal injuries can be associated with mediastinal hemorrhage.
- Neurological deficits are not always present in patients with spinal injuries.
Purpose of the Study:
- To investigate the incidence of spinal injuries in patients with mediastinal hemorrhage following blunt chest trauma.
- To evaluate the role of initial chest radiography in identifying spinal injuries in this patient cohort.
Main Methods:
- Retrospective review of 100 consecutive patients with mediastinal hemorrhage post-blunt chest trauma.
- Clinical assessment for neurological deficits (quadriplegia, paraplegia).
- Radiographic review of supine chest radiographs.
Main Results:
- Nine out of 100 patients had causative spinal fractures or dislocations.
- Spinal injury was suspected in 7 patients due to neurological deficits.
- Two patients with spinal injuries had no neurological deficits and were not initially suspected of having a spinal injury.
Conclusions:
- Spinal injuries are an important, though sometimes occult, cause of mediastinal hemorrhage in blunt chest trauma.
- Supine chest radiography is a valuable tool for identifying potentially unstable spinal injuries during initial triage.
- Early radiographic assessment can aid in preventing further spinal cord injury.