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The hospital mortality rate was 13.9%, and the mean injury severity score (ISS) was 21.8\u2009\u00b1\u200911.8. Seventy percent of patients had no spine injury, 25.9% scored 2\u20133 on the AIS, and 4.1% scored 4\u20136 on the AIS. Among patients with isolated traumatic brain injury (TBI), 26.8% had spinal injuries with an AIS score of 4\u20136. Among patients with multi-system trauma and TBI, 44.7% had spinal injuries that scored 4\u20136 on the AIS. Regression analysis predicted a serious spine injury (SI; AIS 3\u20136) with a prevalence of 10.6% and cervical spine injury (CSI; AIS 3\u20136) with a prevalence of 5.1%. Blunt trauma was a predictor for SI and CSI (OR 4.066 and OR 3.640, respectively; both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and fall\u2009&gt;\u20093\u00a0m for SI (OR 2.243; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) but not CSI (OR 0.636; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Pre-hospital shock was predictive for SI and CSI (OR 1.87 and OR 2.342, respectively; both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and diminished or absent motor response was also predictive for SI (OR 3.171) and CSI (OR 7.462; both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Patients over 65\u00a0years of age were more frequently affected by CSI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In addition to the clinical symptoms of pain, we identify \u20184S\u2019 [spill (fall)\u2009&gt;\u20093\u00a0m, seniority (age\u2009&gt;\u200965\u00a0years), seriously injured, skull\/traumatic brain injury] as an indication for increased attention for CSIs or indication for spinal motion restriction.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-020-01515-w","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T02:02:41Z","timestamp":1602036161000},"page":"1975-1983","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5190-3937","authenticated-orcid":false,"given":"David","family":"H\u00e4ske","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Lefering","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Philipp","family":"Stock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kreinest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The TraumaRegister DGU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,6]]},"reference":[{"key":"1515_CR1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/s10049-015-0118-5","volume":"19","author":"M Kreinest","year":"2016","unstructured":"Kreinest M, Gliwitzky B, Goller S, M\u00fcnzberg M. 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