중증외상환자에서 동반된 척추 및 척수손상에 대한 임상적 분석 = A Clinical Analysis of Spinal Injuries in Severe Trauma Patients

다국어 초록 (Multilingual Abstract)

Background: The traumatic spinal injury is an extremely serious condition that often results in death or disabilities. We investigated epidemiological data on spinal injuries specifically in severe trauma patient admitted to a preliminarily proposed Major Trauma Distinctive Care Center.
Materials and Methods: We reviewed the medical records of 28 severe trauma patients (Injury Severity Score >15) with traumatic spinal (vertebral column or spinal cord) injuries admitted to the emergency medical center in the Kosin University Gospel Hospital (KUGH) from January to October 2009, retrospectively.
Results: The ratio of male to female was 3 to 1. The mean age was 46.5 years. The leading causes of traumatic spinal injury are falls (39.4%). The most common level of injury was cervical (35%) and lumbar (35%) spine. Spinal fracture accounts for 47.8% of all traumatic spinal injury, spinal cord injury 37%, dislocation 8.7% and HNP (herniated nucleus pulposus) 6.5%. The most common type of spinal body fracture was compressive type (58.8%). In spinal cord injury, incomplete injury (64.7%) was more common than complete injury (35.3%) and quadriplegia accounts for 47.1% and paraplegia 52.9%. The most common associated injury was rib fracture & pneumohemothorax (31.2%). 5 patients underwent surgery earlier than 24 hours. The average Injury Severity Score (ISS) was 24.2 and the average Abbreviated Injury Scale Score (AISS) was 3.5.
Conclusion: This clinical analysis is the first basic study for understanding the patterns of the spinal injuries in the severe trauma patients admitted to KUGH emergency medical center which was preliminarily proposed as Major Trauma Distinctive Care Center by Ministry for Health, Welfare and Family Affairs in November 2008. Although this study has only small number of cases during relatively short term period, it will be touchstone of succeeding analysis of spinal injuries in the severe trauma patients. Therefore continuous additional data collections and more precise clinical investigations are suggested

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 1. 연구대상 및 기간
• 2. 연구방법
• 결 과
• 1. 연령 및 성별분포
• 2. 내원수단 및 발생원인
• 3. 척추 손상부위
• 4. 동반손상
• 5. 척추 수술 여부 및 수술명
• 6. 평균 ISS 및 척추손상에 대한 AISS
• 7. 응급실환자의 결과
• 고찰
• 결론
• 참고문헌

참고문헌 (Reference)

1 남용현, "척추 장애자 실태분석" 9 : 120-125, 1985

2 박창일, "척수손상환자의 역학적 연구" 23 (23): 267-275, 1999

3 이국종, "중증 외상센터 설립 방안" 18 (18): 1-16, 2005

4 대한신경외과학회, "신경외과학" 332-333,

5 Andrade MJ, "Traumatic spinal cord injury :neurologic and functional recovery" 20 : 401-406, 2007

6 Stover SL, "The epidemiology and economics of spinal cord injury" 25 : 225-228, 1987

7 Baker SP, "The Injury Severity Score : an update" 16 : 882-885, 1976

8 Association for the Advancement of Automotive Medicine, "The Abbreviated Injury Scale-1990 Revision (AIS-90)"

9 Young JS, "Spinal cord injury statistics : Experience of the regional spinal cord injury system"

10 Leal-Filho MB, "Spinal cord injury : epidemiological study of 386 cases with emphasis on those patients admitted more than four hours after the trauma" 66 : 365-368, 2008

11 Mckinley WO, "Nontraumatic spinal cord injury : Incidence, epidemiology, and functional outcome" 80 : 619-623, 1999

12 Hagen EM, "Mortality after traumatic spinal cord injury : 50 years of follow-up" 2009

13 Divanoglou A, "Incidence of traumatic spinal cord injury in Thessaloniki, Greece and Stockholm, Sweden : a prospective population-based study" 47 : 796-801, 2009

14 Wilmot CB, "Evaluation of acute surgical intervention in traumatic paraplegia" 24 : 71-76, 1986

15 Biering-Sørensen E, "Epidemiology of spinal cord lesions in Denmark" 28 : 105-118, 1990

16 Fiedler IG, "Economics of managed care in spinal cord injury" 80 (80): 1441-1449, 1999

17 Wilberger JE, "Diagnosis and management of spinal cord trauma" 8 : S21-S28, 1991

18 Marshall LF, "Deterioration following spinal cord injury. A multicenter study" 66 : 400-404, 1987

19 Tator CH, "Comparison of surgical and conservative management in 208 patients with acute spinal cord injury" 14 : 60-69, 1987

20 Couris CM, "Characteristics of adults with incident traumatic spinal cord injury in Ontario, Canada" 2009

21 American College of Surgeons, "Advanced trauma life support program for doctors : spine and spinal cord trauma" 215-242, 1997