[High-energy thoracic and lumbar spine fractures at Landspítali 2003-2022 (25 years)]

To investigate the epidemiology of high-energy thoracic and lumbar spine fractures at Landspítali and evaluate their treatment and associated injuries using international injury classification systems.

Medical records were reviewed with regard to age, sex, nationality, length of hospital stay, mechanism of injury, associated injuries, treatment, neurological injury, seasonality, and injury location. Imaging studies were used for diagnosis and for classification of fractures according to the AO injury classification system.

A total of 424 individuals were diagnosed with 596 fractures during the study period. On average, there were 21.2 injuries per year; the mean age was 40.3 years, and men accounted for just over 62% of cases. Motor vehicle collisions were the cause in approximately 21% of cases, rollovers in about 20%, and among rollover accidents, just over 31% involved foreign individuals. The most common fracture levels were L1 (approximately 19% of all fractures) and Th12 (just over 11%). Neurological injury was present in just over 20% of cases involving fractures at Th12, L1, and Th7. Overall, 36% of patients underwent surgical treatment, and an additional 17% received external support. Associated injuries to other parts of the body were present in just over 63% of cases.

On average, approximately two thoracic and lumbar spine fractures caused by high-energy trauma were treated per month at Landspítali during the period 2003-2022. A typical case was a fracture at Th12 or L1 in a 40-year-old man. Patients without neurological deficits had a significantly shorter length of hospital stay. The number of injuries decreased over time, although not statistically significantly; this trend could, for example, be explained by improved vehicle safety equipment.