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- Title
Are severity and location of facial trauma risk factors for cervical spine injuries? 10-year analysis based on the use of the AO spine injury classification and the comprehensive facial injury (CFI) score.
- Authors
Canzi, G.; De Ponti, E.; Spota, A.; Mangini, G.; De Simone, E.; Cioffi, S. P. B.; Altomare, M.; Bini, R.; Virdis, F.; Cimbanassi, S.; Chiara, O.; Sozzi, D.; Novelli, G.
- Abstract
Purpose: This study aims to demonstrate a correlation between cervical spine injury and location and severity of facial trauma. Methods: We did a 10-year retrospective analysis of prospectively collected patients with at least one facial and/or cervical spine injury. We classified facial injuries using the Comprehensive Facial Injury (CFI) score, and stratified patients into mild (CFI < 4), moderate (4 ≤ CFI < 10) and severe facial trauma (CFI ≥ 10). The primary outcome was to recognize the severity and topography of the facial trauma which predict the probability of associated cervical spine injuries. Results: We included 1197 patients: 78% with facial injuries, 16% with spine injuries and 6% with both. According to the CFI score, 48% of patients sustained a mild facial trauma, 35% a moderate one and 17% a severe one. The midface was involved in 45% of cases, then the upper facial third (13%) and the lower one (10%). The multivariate analysis showed multiple independent risk factors for associated facial and cervical spine injuries, among them an injury of the middle facial third (OR 1.11 p 0.004) and the facial trauma severity, having every increasing point of CFI score a 6% increasing risk (OR 1.06 p 0.004). Conclusions: Facial trauma is a risk factor for a concomitant cervical spine injury. Among multiple risk factors, severe midfacial trauma is an important red flag. The stratification of facial injuries based on the CFI score through CT-scan images could be a turning point in the management of patients at risk for cervical spine injuries before imaging is available.
- Subjects
CERVICAL vertebrae; FACIAL injuries; SPINE; WOUNDS &; injuries; MULTIVARIATE analysis
- Publication
European Spine Journal, 2024, Vol 33, Issue 1, p198
- ISSN
0940-6719
- Publication type
Article
- DOI
10.1007/s00586-023-08037-0