Traumatic lumbar disc injury - radiology and biomechanics

Abstract Background Traumatic disc injury is typically diagnosed in patients with multiple injuries resulting from high-energy trauma. However, patients often claim a causal link between minor trauma and disc injury. Research Questions: Do traumatic lumbar disc injuries occur in low-energy trauma or accidents? Are there always accompanying spinal injuries? What are the main injury mechanisms? Material and Methods Two data sources were surveyed: Patients treated at a tertiary centre (UKJ) and the NHTSA (National Highway Traffic Safety Administration) accident database. The UKJ data underwent a second neuroradiological look, and the discharge summaries and surgical protocols were analysed. In addition to the NHTSA case evaluation, an exploratory risk assessment based on cumulative frequency distributions is provided. Results Of the 33 UKJ patients, most sustained falls from a standing height, as well as from a greater height. Trauma-related neuroradiological findings and accompanying spinal fractures (mostly compression-type) were present in all UKJ cases. Two out of ten occupants in the NHTSA database sustained low-velocity accidents without accompanying injuries. Discussion and Conclusion Although rare, traumatic lumbar disc injuries can occur during low-energy events, such as falling from a standing height. However, this presumably affects older patients or those with relevant pre-existing spinal conditions. Due to the small number of NHTSA cases, it cannot be concluded that traumatic lumbar disc injuries are always associated with high accident severity. Nevertheless, the reliability of injury documentation in accident databases appears to be limited, particularly in cases of rare injury patterns.