Spinal Injury Rate Much Higher in Recent Wars

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EL PASO, TX — More than 10% of wounded troops serving in Iraq and Afghanistan have suffered spinal injuries, and a new study said that is a much higher rate than in previous wars.

The report, published recently in the journal Spine, is based on research led by Andrew J. Schoenfeld, MD, of Beaumont Army Medical Center in El Paso. 1

“The incidence of spine trauma in modern warfare exceeds reported rates from earlier conflicts,” according to the study, which suggests that the significant increase in spinal injuries may reflect “enhanced personnel protection and medical advancements” that have improved survival from combat injuries that would previously have been lethal.

For the study, investigators searched casualty records for the years 2005 to 2009 in the DoD Trauma Registry, which includes detailed information on combat-related spine trauma among soldiers deployed to Iraq and Afghanistan.

They found that spinal injuries were present in 872 out of 7,877 casualties analyzed — a rate of 11.1%. More than 80% of the spinal injuries were fractures, with about 75% of them caused by explosions and about 15% by gunshot wounds.

About 3% of servicemembers spinal injuries died after receiving medical care. The study did not include those who died before receiving medical care.

Overall, spinal trauma occurred at a rate of 4.4 injuries per 10,000 servicemembers deployed to Iraq or Afghanistan, including a 4.0 per 10,000 rate of spinal fractures. By comparison, the anticipated rate of injuries to the limbs was about 15 per 10,000 personnel.

Other findings include that spinal injuries were more likely to occur:

  • Among troops fighting in Afghanistan as compared with Iraq, although spinal injuries caused by gunshot wounds were more frequent in Iraq;
  • In Army personnel than in members of other service branches; and
  • During the Iraq War “surge” year of 2007.

“The 11.1 percent rate of spinal injuries … represents the highest published statistic for Iraq, Afghanistan, or any other American conflict,” the authors wrote, suggesting that spinal injury rate could be as much as 10 times higher than in the Vietnam War.

In the past, most soldiers with spinal trauma were injured so severely that survival would have been impossible, the authors pointed out.

“[A]dvances in military medicine are now enabling soldiers to reach medical facilities where their spinal wounds can be identified,” according to the article, which also emphasized that modern military-grade explosives are destructive enough to cause concurrent injuries to the limbs and/or head and neck.

1 Andrew J. Schoenfeld, Matthew D. Laughlin, Brendan J. McCriskin, Julia O. Bader, Brian R. Waterman, Philip J. Belmont. Spinal Injuries in United States Military Personnel Deployed to Iraq and Afghanistan. Spine, 2013: 1 DOI: 10.1097/BRS.0b013e31829ef226

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