• Ronen Blecher, Emre Yilmaz, Basem Ishak, Alexander von Glinski, Marc Moisi, Rod J Oskouian, Joseph Dettori, Motti Kramer, Michael Drexler, and Jens R Chapman.
• Swedish Neuroscience Institute, Seattle, WA, USA.
• Eur Spine J. 2020 Oct 1; 29 (10): 2543-2549.

BackgroundTraumatic spinal injuries can be life-threatening conditions. Despite numerous epidemiological studies, reports on specific spinal regions affected are lacking.HypothesisWe hypothesized that fractures at specific regions, such as the cervical spine (including the axis segment), have been affected to a greater degree. We also hypothesized that advanced age may be a significant contributing factor.ObjectiveTo longitudinally analyze trend of spine fractures and specific fracture subtypes.Study DesignLongitudinal trend analysis of discharged patient state database.Patient SampleDischarged patient's data from 15 years (2003-2017) METHODS: We retrieved pertinent ICD-9 and 10 codes depicting fractures involving the entire spine and specific subtypes. To assess possible association with age, we analyzed the trend of the average age in patients discharged with and without spinal fractures as well as in specific fracture subtypes. Similar analysis was performed for other common fragility fractures. FDA device/drug status: The manuscript submitted does not contain information about medical device(s) or drug(s).ResultsWe found that within 15 years, the overall proportion of spinal fractures has increased by 64% (from 0.47 to 0.77% of all discharged patients) with the greatest increase noted in fractures of the cervical spine (123%) and specifically of the second cervical vertebra (84%). Age was found to have increased more in patients with spinal fractures than in the general discharged population. Surprisingly, other non-spinal fractures among patients above 60 remained relatively stable, demonstrating a spine-specific effect.ConclusionsOur findings confirm a recent increase in all spinal fractures and in the cervical and sacral regions in particular. Advanced age may be an important underlying factor.

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