M. Khalil1, P. Rhee1, T. Orouji Jokar1, N. Kulvatunyou1, A. A. Haider1, T. O’Keeffe1, A. Tang1, G. Vercruysse1, L. Gries1, R. S. Friese1, B. Joseph1 1University Of Arizona,Trauma/Surgery/Medicine,Tucson, AZ, USA
Introduction:
Isolated transverse process fractures (iTPF) of the lumbar spine have been shown to be associated with development of non-spine associated injuries (NSAI). However; the level of lumbar spine fracture associated with type of NSAI remains unknown. The aim of this study was to determine the association between level of lumbar iTPF and type of NSAI.
Methods:
We performed a 3-year retrospective analysis of all patients with spine fractures at our level 1 trauma center. Patients with lumbar iTPF were included. Patients were stratified based on the level of lumbar spine fracture. Outcome measure was development of NSAI. We defined NSAI as abdominal injury (solid or hollow viscus), thoracic injury, pelvic or sacral fracture, or extremity fracture. Multivariate regression analysis was performed to identify association between location of fracture and development of NSAI.
Results:
A total of 198 patients with lumbar iTPF were included of which, 67.2% (n=132) patients developed NSAI. L3 (48%) and L4 (35.9%) were the most common location of iTPF. L5 iTPF had 83.6% sensitivity and 89.8% negative predictive value (NPV) for predicting pelvic/sacral fracture. L2 iTPF predicted the development of solid organ injury with 78% sensitivity.
Conclusion:
Level of isolated lumbar transverse process fracture determines the type of NSAI. The presence of L2 iTPF was independently associated with solid organ injury while L5 iTPF was associated with pelvic/sacral fractures. Level of lumbar iTPF can serve as a roadmap for clinicians in assessment of trauma patients.
