Hyperextension Spinal Fractures: Epidemiological Profile and Surgical Outcomes in a Trauma Center

Introduction: In a population affected by ankylosing spinal conditions, such as ankylosing spondylitis (AS),the risk of spinal injuries are significantly larger than the normal population. This is primarily due to the increased stiffness of the spine in these patients, making it more susceptible to severe injuries.
The objective of this study is to present epidemiological data on patients with AO type B3 spinal fractures treated at a major trauma center in the southern region of the Brazil. Additionally, we aim to compare the findings of this study with the existing literature to date.

Methods: A longitudinal, observational, and retrospective study evaluating the epidemiological profile of 20 patients with hyperextension spinal fractures from January 2013 to October 2021 in a trauma hospital database in Brazil. The variables analyzed included age, gender, affected spinal segment, mechanism of injury, type of treatment, neurological impairment before and after surgery, if done.

Results: A total of 20 patients were evaluated, all presenting with anterior ligamentous injuries at a single level. The most prevalent level was cervical, with 13 cases, and the most common mechanism of injury was a same-level fall, observed in 11 cases, followed by motor vehicle accidents in 4 cases. Nine patients presented with neurological deficits after the trauma, and 8 of these patients continued to have some level of deficit despite the proposed treatment. Seventeen cases were treated surgically, while only 3 were managed conservatively due to absolute contraindications to surgical procedures.

Conclusion : Hyperextension spinal fractures are rare injuries but have a high potential for permanent damage, often affecting a population that is challenging to diagnose due to comorbidities. Therefore, we recommend that all older patients with ankylosing spinal conditions be investigated for spinal injuries regardless of the presence or absence of localized complaints.