Epidemiological Analysis of Patients Victims of Surgical Thoracic/Lumbar Fractures Treated at a Tertiary Hospital in Brazil

Resumo

Introdução: A lesão da medula espinhal, uma das sequelas mais temidas das fraturas da coluna vertebral, é uma causa comum de incapacidade funcional permanente em indivíduos jovens, com taxas significativas de morbidade e mortalidade. De acordo com esta perspectiva, explorar o padrão epidemiológico dessas lesões é o primeiro passo para desenvolver estratégias preventivas visando evitar complicações e melhorar a tomada de decisão. Objetivo: analisar o perfil epidemiológico de pacientes operados que foram vítimas de fraturas toracolombares. Métodos: Estudo descritivo retrospectivo de corte transversal com amostra composta por 223 fraturas toracolombares ocorridas entre 2015 e 2019. Os dados (sexo, idade, local de origem, etiologia da lesão, escala de Frankel para avaliação do déficit neurológico e segmento vertebral afetado) foram extraídos dos registros de pacientes vítimas de trauma na coluna torácica e lombar e tratados cirurgicamente na instituição. Resultados: Foram analisados um total de 223 pacientes, dos quais 164 (73,5%) eram homens. A idade média foi de 35,9 ± 14,3 anos. A maioria dos traumas foi causada por acidentes de motocicleta (36,7%), seguidos por quedas de altura (31,8%) e acidentes de carro (17,0%). A principal causa de trauma em homens foram acidentes de motocicleta (39,0%), enquanto em mulheres foram quedas de altura (35,5%). O segmento mais afetado foi a coluna toracolombar em 118 (52,9%) casos, seguido pelo segmento torácico em 78 (34,9%) casos. Um total de 46,1% dos pacientes foi admitido com escore Frankel E. Acidentes de trânsito foram a principal causa de déficits motores completos na admissão hospitalar (Frankel A). Conclusões: Entre os pacientes tratados cirurgicamente por trauma na coluna torácica e/ou lombar, houve predominância de acidentes de motocicleta, seguidos por acidentes de carro, e os homens apresentaram maior propensão a fraturas. Além disso, a região de transição toracolombar foi a mais afetada, no entanto, as lesões na região torácica exibiram pior status de Frankel.

Palavras-chave

Palavras-chave: Toracolombar; Trauma; Lesão da medula espinhal; Epidemiologia; Incidência

Abstract

Introduction: Spinal cord injury, one of the most feared sequelae of spinal fractures, is a common cause of permanent functional disability in young individuals, with significant morbidity and mortality rates. According to this perspective, exploring the epidemiological pattern of these lesions is the first step to develop preventive strategies to avoid complications and improve decision-making. Objective: to analyze the epidemiological profile of operated patients who were victims of thoracolumbar fractures. Methods: retrospective cross-sectional descriptive study with sample consisting of 223 thoracolumbar fractures that occurred between 2015 and 2019. Data (gender, age, place of origin, etiology of the injury, Frankel scale for assessing neurological deficit, and affected vertebral segment) were extracted from the records of patients who were victims of trauma to the thoracic and lumbar spine and surgically treated at the institution. Results: A total of 223 patients were analyzed, of whom 164 (73.5%) were men. The mean age was 35.9 ± 14.3 years. Most traumas were caused by motorcycle accidents (36.7%), followed by falls from heights (31.8%) and car accidents (17.0%). The main cause of trauma in men was motorcycle accidents (39.0%), while in women it was falls from height (35.5%). The most affected segment was the thoracolumbar spine in 118 (52.9%) cases, followed by the thoracic segment in 78 (34.9%) cases. A total of 46.1% of the patients were admitted with a Frankel E. Traffic accidents were the main cause of complete motor deficits at hospital admission (Frankel A). Conclusions: Among patients surgically treated for trauma to the thoracic and/or lumbar spine there was a predominance of motorcycle accidents, followed by car accidents, and men were more prone to fractures. In addition, the thoracolumbar transition region was the most affected. However, lesions in the thoracic region exhibited worse Frankel status.

Keywords

Keywords: Thoracolumbar; Trauma; Spinal cord injury; Epidemiology; Incidence

References

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Epidemiological Analysis of Patients Victims of Surgical Thoracic/Lumbar Fractures Treated at a Tertiary Hospital in Brazil

Análise Epidemiológica de Pacientes Vítimas de Fraturas Cirúrgicas Torácicas/Lombares Tratados em um Hospital Terciário no Brasil

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JBNC Brazilian Journal of Neurosurgery

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