Post-traumatic cervical spine epidural hematoma

Incidence and risk factors

Pedro A. Ricart, Ravi Verma, Steven J. Fineberg, Kyle Y. Fink, Paul A. Lucas, Yungtai Lo, David E. Asprinio, Louis F. Amorosa

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)2529-2533
Number of pages5
JournalInjury
Volume48
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Hematoma
Spine
Incidence
International Normalized Ratio
Wounds and Injuries
International Classification of Diseases
Conflict of Interest
Spinal Cord Compression
Ankylosing Spondylitis
Registries
Albumins
Blood Platelets

Keywords

  • Ankylosing spondylitis
  • Cervical spine
  • Cord compression
  • Injury severity score
  • INR
  • MRI
  • Spinal epidural hematoma
  • Trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Cite this

Post-traumatic cervical spine epidural hematoma : Incidence and risk factors. / Ricart, Pedro A.; Verma, Ravi; Fineberg, Steven J.; Fink, Kyle Y.; Lucas, Paul A.; Lo, Yungtai; Asprinio, David E.; Amorosa, Louis F.

In: Injury, Vol. 48, No. 11, 01.11.2017, p. 2529-2533.

Research output: Contribution to journalArticle

Ricart, PA, Verma, R, Fineberg, SJ, Fink, KY, Lucas, PA, Lo, Y, Asprinio, DE & Amorosa, LF 2017, 'Post-traumatic cervical spine epidural hematoma: Incidence and risk factors', Injury, vol. 48, no. 11, pp. 2529-2533. https://doi.org/10.1016/j.injury.2017.08.060
Ricart PA, Verma R, Fineberg SJ, Fink KY, Lucas PA, Lo Y et al. Post-traumatic cervical spine epidural hematoma: Incidence and risk factors. Injury. 2017 Nov 1;48(11):2529-2533. https://doi.org/10.1016/j.injury.2017.08.060
Ricart, Pedro A. ; Verma, Ravi ; Fineberg, Steven J. ; Fink, Kyle Y. ; Lucas, Paul A. ; Lo, Yungtai ; Asprinio, David E. ; Amorosa, Louis F. / Post-traumatic cervical spine epidural hematoma : Incidence and risk factors. In: Injury. 2017 ; Vol. 48, No. 11. pp. 2529-2533.
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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.",
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T1 - Post-traumatic cervical spine epidural hematoma

T2 - Incidence and risk factors

AU - Ricart, Pedro A.

AU - Verma, Ravi

AU - Fineberg, Steven J.

AU - Fink, Kyle Y.

AU - Lucas, Paul A.

AU - Lo, Yungtai

AU - Asprinio, David E.

AU - Amorosa, Louis F.

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N2 - 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.

AB - 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.

KW - Ankylosing spondylitis

KW - Cervical spine

KW - Cord compression

KW - Injury severity score

KW - INR

KW - MRI

KW - Spinal epidural hematoma

KW - Trauma

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