اﭘﯿﺪﻣﯿﻮﻟﻮژي ﺷﮑﺴﺘﮕﯽ ﺳﺘﻮن ﻓﻘﺮات ﻧﺎﺷﯽ از ﺗﺮوﻣﺎ: ﯾﮏ ﻣﻄﺎﻟﻌﻪ از ﺑﯿﻤﺎرﺳﺘﺎن ﻣﺮﮐﺰ ﺗﺮوﻣﺎ در ﺟﻨﻮب ﺷﻬﺮ ﺗﻬﺮان

Epidemiology of Traumatic Spinal Fracture: A Study of Trauma Hospital in Southern Tehran

ﻣﯿﻨﻪ و ﻫﺪف: ﺗﺮوﻣﺎ ﺷﺎﯾﻌﺘﺮﯾﻦ ﻋﻠﺖ ﻣﺮگ و ﻣﯿﺮ در ﺟﻮاﻧﺎن اﺳﺖ و آﺳﯿﺐ ﻫﺎي ﺳﺘﻮن ﻓﻘﺮات ﺑﺎ آﺛﺎر و ﭘﯿﺎﻣﺪﻫﺎي زودرس و دﯾﺮرس اﺟﺘﻤﺎﻋﯽ و اﻗﺘﺼﺎدي ﻫﻤﺮاه اﺳﺖ و ﻣﻨﺠﺮ ﺑﻪ ﻧﺎﺗﻮاﻧﺎﯾﯽﻫﺎي داﯾﻤﯽ و ﮐﺎﻫﺶ اﻣﯿﺪ ﺑﻪ زﻧﺪﮔﯽ ﻣﯽﺷﻮد. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ ﺷﯿﻮع آﺳﯿﺐ ﻫﺎي ﺳﺘﻮن ﻓﻘﺮات و آﺳﯿﺐ ﻫﺎي ﻫﻤﺮاه آن در ﺑﯿﻤﺎران ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ارﺟﺎﻋﯽ ﺗﺮوﻣﺎ از ﺳﻦ ده ﺳﺎل ﺑﻪ ﺑﺎﻻﺗﺮ اﺳﺖ. ﻣﻮاد و روش ﻫﺎ: ﻣﻄﺎﻟﻌﻪ ﺑﺮ روي ﺗﻌﺪاد 680 ﺑﯿﻤﺎر ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﺑﺎ آﺳﯿﺐ ﺳﺘﻮن ﻓﻘﺮات ﺑﺮ اﺳﺎس ﻣﻄﺎﻟﻌﻪ ﭘﺮوﻧﺪهﻫﺎ و ﺗﺼﻮﯾﺮﺑﺮداري اﻧﺠﺎم ﺷﺪه ﺻﻮرت ﮔﺮﻓﺖ و در ﻧﻬﺎﯾﺖ ﺗﻌﺪاد 522 ﺑﯿﻤﺎر ﺟﺎﻣﻌﻪ آﻣﺎري را ﺗﺸﮑﯿﻞ دادﻧﺪ. ﺗﻤﺎﻣﯽ ﺑﯿﻤﺎران ﺑﺮ اﺳﺎس ﮐﺘﺎب ﻃﺒﻘﻪﺑﻨﺪي ﺑﯿﻤﺎريﻫﺎ ICD10 ﭘﺬﯾﺮش ﺷﺪه ﺑﯿﻦ ﺳﺎلﻫﺎي 1394 و 1395 ﺑﻮدﻧﺪ. اﻃﻼﻋﺎت ﺑﺪﺳﺖ آﻣﺪه ﺷﺎﻣﻞ دﻣﻮﮔﺮاﻓﯽ ﺑﯿﻤﺎران ﺷﺎﻣﻞ ﺳﻦ، ﺟﻨﺴﯿﺖ، ﻣﮑﺎﻧﯿﺰم ﺗﺮوﻣﺎ، آﺳﯿﺐ ﻫﺎي ﻫﻤﺮاه و ﻧﻮع ﺷﮑﺴﺘﮕﯽ ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮنﻫﺎي آﻣﺎري ﺗﻮﺻﯿﻔﯽ )ﻓﺮاواﻧﯽ، ﻣﯿﺎﻧﮕﯿﻦ و اﻧﺤﺮاف ﻣﻌﯿﺎر( و اﺳﺘﻨﺒﺎﻃﯽ )آزﻣﻮن ﮐﺎي دو، ﺗﯽ ﺗﺴﺖ( ﺗﻮﺳﻂ ﺑﺮﻧﺎﻣﻪ ﻧﺮماﻓﺰاري SPSS ﺑﺮرﺳﯽ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: از ﻣﯿﺎن 522 ﺑﯿﻤﺎر ﺑﺮرﺳﯽ ﺷﺪه، ﻣﺮدان ﺑﺎ ﺗﻌﺪاد 397 ﻧﻔﺮ ﯾﻌﻨﯽ 76/1% و زﻧﺎن ﺑﺎ ﺗﻌﺪاد 125 ﻧﻔﺮ ﯾﻌﻨﯽ 23/9% ﺗﻮزﯾﻊ ﺟﻨﺴﯿﺘﯽ را ﺗﺸﮑﯿﻞ دادهاﻧﺪ و ﺑﺎﻻﺗﺮﯾﻦ رده ﺳﻨﯽ ﻣﺮﺑﻮط ﺑﻪ 21 ﺗﺎ 30 ﺳﺎل ﺑﺎ ﺗﻌـﺪاد 157 ﻧﻔﺮ ﯾﻌﻨﯽ 27/1% ﺑﻮد. ﺣﻮادث ﺗﺮاﻓﯿﮏ ﺑﺎ 232 ﻧﻔﺮ ﯾﻌﻨﯽ 44/4% و ﺳﻘـﻮط از ﺑﻠﻨﺪي ﺑﺎ 140 ﻧﻔﺮ ﯾﻌﻨﯽ 26/8% ﺷﺎﯾﻌﺘﺮﯾﻦ ﻋﻠﻞ ﻣﻨﺠـﺮ ﺑﻪ ﺷﮑﺴﺘـﮕﯽ ﺑﻮدﻧﺪ و ﻫﻤﭽﻨﯿﻦ ﺷﺎﯾﻌﺘﺮﯾﻦ ﻣﺤﻞ ﺷﮑﺴﺘﮕﯽ ﻧﺎﺣﯿﻪ ﻣﺤﻞ ﺗﻼﻓﯽ ﺗﻮراﮐـﻮﻻﻣﺒﺮ )T11-L2( ﺑﺎ 234 ﻧﻔـﺮ ﯾﻌﻨﯽ 44/8% و آﺳﯿـﺐ ﺑﻪ ﺳﺮ ﺑﺎ 113 ﻧﻔﺮ 21/6%، اﻧﺪام ﺗﺤﺘـﺎﻧﯽ ﺑﺎ 85 ﻧﻔـﺮ 16/3% و ﻗﻔﺴﻪ ﺻﺪري ﺑﺎ 54 ﻧﻔﺮ 10/3%، ﺷﺎﯾﻊﺗﺮﯾﻦ آﺳﯿﺐ ﻫﺎي ﻫﻤﺮاه ﺑﻮدﻧﺪ. ﻧﻧﺘﯿﺠﻪ ﮔﯿـﺮي: در ﺑﺮرﺳﯽ ﺻﻮرت ﮔﺮﻓﺘﻪ ﺑﺮ روي ﻋﻮاﻣﻞ ﻣﺆﺛﺮ ﺑﺮ ﻣﺼﺪوﻣﯿﺖﻫﺎي ﺧﺎرج ﺳﺘﻮن ﻓﻘﺮات ﺑﺎ ﺳﻦ و ﺟﻨﺴﯿﺖ راﺑﻄﻪاي وﺟﻮد ﻧﺪاﺷﺖ، اﻣﺎ در ﻣﺘﻐﯿﺮ ﻋﻠﺖ ﺣﺎدﺛﻪ راﺑﻄﻪ ﻣﻌﻨﺎداري ﺑﺎ ﻋﻮاﻣﻞ ﻣﺆﺛﺮ ﺑﺮ ﻣﺼﺪوﻣﯿﺖﻫﺎي ﺧﺎرج از ﺳﺘﻮن ﻓﻘﺮات وﺟﻮد دارد. ﺗﻮزﯾﻊ ﺷﮑﺴﺘﮕﯽﻫﺎ ﺑﻪ ازاي ﻫﺮ ﻣﻬﺮه در ﺳﺘﻮن ﻓﻘﺮات ﺑﺮ اﺳﺎس ﻃﺒﻘﻪﺑﻨﺪي ﻓﺮاﻧﮑﻞ و ﻣﻌﯿﺎر AO راﺑﻄﻪ ﻣﻌﻨﺎداري ﺑﺎ ﯾﮑﺪﯾﮕﺮ دارﻧﺪ، ﻫﻤﭽﻨﯿﻦ ﺑﯿﻦ ردهﻫﺎي ﻣﺨﺘﻠﻒ ﻃﺒﻘﻪﺑﻨﺪي ﻓﺮاﻧﮑﻞ ﺑﺎ ﻣﻌﯿﺎر AO راﺑﻄﻪ ﻣﻌﻨﺎداري وﺟﻮد داﺷﺖ.

Introduction & Objective: Trauma is the most common cause of mortality in young people, and spinal fracture and cord injuries are associated with early and late social and economic consequences and lead to permanent disabilities and reduced life expectancy. The aim of this study was to evaluate the spinal canal damage and its associated traumatic injury in patients referring to trauma referral hospital at the age of 10 years. Materials & Methods: 680 patients who were referred to the university hospital with spinal fractures based on case studies and imaging were included in our study. All patients were ICD10 classified according to the ICD10 classification between 2015 and 2016. Age, sex, traumatic mechanism, traumatic injury and fracture type date demographically analyzed. Results: Among 522 patients examined, the incidence of male to female was 2.3 to 1 and it was between the age ranges of 21 to 45 years. Traffic accidents and falls were the most common causes of fracture. In addition, the most common fracture site was thoracolumbar region (T11-L2) and injury to the head, lower extremity and chest wall were the most common coexisted injuries. Conclusions: There was no relationship between the factors affecting external spinal injuries with age and gender, but there was a significant relationship between the cause of the accident and the factors affecting non-spinal injuries. The distribution of fractures per spine in terms of Frankl's classification and AO criteria has a significant relationship with each other. There was a significant relationship between Frankl's classifications in AO criteria.