Risk factors for noncontiguous spinal fractures among elderly patients presenting with traumatic spinal fractures: a retrospective case‒control study

World Neurosurg. 2025 Jan 3:123651. doi: 10.1016/j.wneu.2024.123651. Online ahead of print.

Abstract

Objective: Risk factors for noncontiguous spinal fractures (NSFs), which are important for early, timely diagnoses and treatments of elderly individuals with traumatic spinal fractures, have not been discussed in depth. Thus, this study aimed to investigate the risk factors for noncontiguous spinal fractures (NSFs).

Methods: The records of 1,415 elderly patients (aged 60 years and over) who presented with TSFs between 2013 and 2019 were retrospectively reviewed. The patients' clinical and radiographic records were reviewed.

Results: The patients were divided into an NSF group (n=281 patients) and a control group (n=1,134 patients). Univariate analysis revealed that female sex (P=0.013), fractures with no obvious incentives (P=0.003), osteoporosis (P=0.003), occurrence in the spring (P<0.05), and previous vertebral fractures (P<0.001) were associated with NSFs. Multivariate logistic regression revealed that fractures occurring in the spring (P<0.05) and a history of previous vertebral fractures (P<0.001) were independent risk factors for NSFs.

Conclusion: Independent risk factors for NSFs among the elderly population include fractures that occur in the spring and a history of previous vertebral fractures, which is important for determining the surgical segment.

Keywords: elderly; noncontiguous spinal fractures; risk factors; spinal fractures.