The Prevalence of Cervical Spine Injury, Head Injury, or Both with Isolated and Multiple Craniomaxillofacial Fractures

TLDR

Craniomaxillofacial fractures are variably associated with cervical spine and head injuries, and missing these life‑threatening injuries can have devastating consequences. The study aimed to determine the prevalence of cervical spine and/or head injuries in patients with isolated or multiple craniomaxillofacial fractures across U.S. trauma centers. A retrospective chart review of ICD‑9 codes from the National Trauma Data Bank (2002‑2006) covering over 1.3 million trauma patients was performed.

Abstract

Background: Several studies have reported the relationship among craniomaxillofacial fractures, cervical spine injuries, and head injuries with varying results. Life-threatening injuries to the head and cervical spine with devastating consequences cannot be missed by reconstructive surgeons during evaluation of facial trauma. The purpose of this study was to establish the prevalence of cervical spine injuries and/or head injuries with isolated and multiple craniomaxillofacial fractures at trauma centers across the United States. Methods: The study was a retrospective chart review of International Classification of Diseases, Ninth Revision diagnosis and procedure codes from the National Trauma Data Bank between the years 2002 and 2006. This included data on over 1.3 million trauma patients from the United States and Puerto Rico. Results: In the setting of an isolated mandible, nasal, orbital floor, malar/maxilla, or frontal/parietal bone fracture, cervical spine injury ranged from 4.9 to 8.0 percent, head injury ranged from 28.7 to 79.9 percent, and concomitant cervical spine and head injury was present in 2.8 to 5.8 percent. In the setting of two or more facial fractures, the prevalence of cervical spine injury ranged from 7.0 to 10.8 percent. The prevalence of head injury ranged from 65.5 to 88.7 percent, and the prevalence of concomitant cervical spine and head injury ranged from 5.8 to 10.1 percent. Conclusion: This article represents the most accurate description of the prevalence of cervical spine and/or head injury with craniomaxillofacial fracture at trauma centers in the United States.