Spine Trauma in Octogenarian Patients

Introduction:
Spine trauma is a growing phenomenon, especially in geriatric patients[1]. Traumatic spine injuries are perceived as a major factor in significant morbidity, disability, and mortality[2]. To-date, there is limited information regarding the characteristics of spine trauma in patients 80 year old or older.

Materials and Methods:
Comprehensive data regarding all registered octogenarian patients with spinal column injuries, in a Level I trauma center between the years 2015 to 2020 was collected. The extent of traumatic spine injuries in adults over 80, and their consequences was assessed. The gathered information was compared with data of a younger control group (age 19-70), with similar injuries.

Results:
125 octogenarians underwent spine trauma between 2015 and 2020 (65F:60M). The average ISS score was 12.65. The most common comorbidity was a head injury in 33% of patients. There were 42 cervical injuries, 21 thoracic injuries, 41 injuries in the thoracolumbar junction and 18 lumbar injuries. There were 13 extension type injuries of the spine. 26% of the patients underwent surgery for the fractures. Mortality rate 9% in the first month increasing to 20% within one year from the trauma. When comparing the octogenarian patients to the younger controls, they demonstrated similar comorbidities, ISS score, hospitalization time and surgical rate, however their mortality rates was significantly higher (P<0.001). The highest mortality rate was seen in extension type injuries.

Conclusion:
Trauma in the octogenarian population is common, with high ISS scores and a high mortality rate. Extension type injuries have the highest rate of morality and need to be identified and treated promptly. Further research needs to be extended into this type of population.

[1] https://oce.ovid.com/article/00005373-200706001-00046/HTML
[2] https://thejns.org/focus/view/journals/neurosurg-focus/25/5/article-pE16.xml