[The importance of Injury Severity Score (ISS) in the management of thoracolumbar burst fracture]. 2009

Rodrigo Rezende, and Osmar Avanzi
Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, SP, Brasil.

OBJECTIVE There are few publications which relate the injury severity score (ISS) to the thoracolumbar burst fractures. For that reason and for the frequency in which they occur, we have evaluated the severity of the trauma in these patients. METHODS We have evaluated 190 burst fractures in the spinal cord according to Denis, using the codes of Abbreviated Injury Scales (AIS) for the calculation of the ISS, which uses the three parts of the human body with major severity. These lesions are a squared number and the results are summed up. RESULTS Among 190 cases evaluated, the median value of the ISS was 13 and the average was 14,4. Males presented a higher ISS than females. The young adult patients presented an average and a median value of the ISS higher than the old patients. The higher the ISS is, the longer the hospitalization period is, except for the patients with the ISS over 35. The fractures in thoracic level show the ISS higher than the rest. The ISS is directly related to surgical treatment and mortality. CONCLUSIONS The ISS values which were found show that a less severe trauma can cause a burst thoracic or lumbar spinal cord fracture. The value of the ISS has not shown correlation to the sex and the fracture level, but it is proportional to the hospitalization period, the surgical treatment and the mortality rate. This result shows a value which is inversely proportional to the age of the patients.

UI MeSH Term Description Entries
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D008297 Male Males
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013904 Thoracic Vertebrae A group of twelve VERTEBRAE connected to the ribs that support the upper trunk region. Vertebrae, Thoracic
D015601 Injury Severity Score An anatomic severity scale based on the Abbreviated Injury Scale (AIS) and developed specifically to score multiple traumatic injuries. It has been used as a predictor of mortality. ISS Score,Injury Severity Scores,Score, Injury Severity,Scores, Injury Severity
D016103 Spinal Fractures Broken bones in the vertebral column. Hangman Fracture,Hangman's Fracture,Fracture, Hangman,Fracture, Hangman's,Fracture, Spinal,Fractures, Spinal,Hangmans Fracture,Spinal Fracture

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