Epidemiology of Traumatic Cervical Spine Fractures in the Norwegian Population

Introduction The incidence of traumatic cervical spine fractures (CS-fx) in the general population is largely unknown. Former published data describe the incidence in different subpopulations, such as trauma center patients, head injury patients, osteoporotic patients, and military populations. Norway is a small country in Northern Europe with 5 million inhabitants. All acute traumatic cervical spine injuries are treated in government- owned public health care. The aim of this study was to estimate the incidences of CS-fx and of open surgical fixation of CS-fx in the Norwegian population. Material and Methods The Norwegian Patient Register (NPR) is an administrative database that contains activity data from all Norwegian government-owned hospitals and outpatient clinics. Reporting to NPR is mandatory and linked to the funding of health services. The diagnoses and procedures are coded according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the NOMESCO Classification of Surgical Procedures (NCSP), respectively. We retrieved information on all CS-fx between 2009 and 2012 from the NPR. Updated information on the date of death is included through routine linkage to the General Register Office. Results Between 2009 and 2012, a total of 2,963 patients had one or more CS-fx. The median age was 54 years, and 69% of the patients were male. The incidence of CS-fx was 15.0/100,000/year. A total of 19% of the patients were treated with open surgery, resulting in an estimated incidence of 2.9/100,000/ year for surgery for CS-fx in the Norwegian population. The 1- and 3-month mortality rates were 4 and 6%, respectively. Conclusion To the best of our knowledge, this is the first registry-based study of the epidemiology of CS-fx in a general population. Our estimate of the incidence of CS-fx in the total Norwegian population was 15/100,000/year. The incidence of open surgery for CS-fx in the Norwegian population was estimated to be 2.9/100,000/year.