{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:26:04Z","timestamp":1790270764635,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011102","name":"Seventh Framework Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007731","name":"ZNS - Hannelore Kohl Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007731","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018727","name":"One Mind","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018727","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009006","name":"Integra LifeSciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Spine injury is highly prevalent in patients with poly-trauma, but data on the co-occurrence of spine trauma in patients with traumatic brain injury (TBI) are scarce. In this study, we used the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) database to assess the prevalence, characteristics, and outcomes of patients with TBI and a concurrent traumatic spinal injury (TSI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from the European multi-center CENTER-TBI study were analyzed. Adult patients with TBI (\u226518 years) presenting with a concomitant, isolated TSI of at least serious severity (Abbreviated Injury Scale; AIS \u22653) were included. For outcome analysis, comparison groups of TBI patients with TSI and systemic injuries (non-isolated TSI) and without TSI were created using propensity score matching. Rates of mortality, unfavorable outcomes (Glasgow Outcome Scale Extended; GOSe &amp;lt; 5), and full recovery (GOSe 7\u20138) of all patients and separately for patients with only mild TBI (mTBI) were compared between groups at 6-month follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 164 (4%) of the 4,254 CENTER-TBI core study patients suffered from a concomitant isolated TSI. The median age was 53 [interquartile range (IQR): 37\u201366] years and 71% of patients were men. mTBI was documented in 62% of cases, followed by severe TBI (26%), and spine injuries were mostly cervical (63%) or thoracic (31%). Surgical spine stabilization was performed in 19% of cases and 57% of patients were admitted to the ICU. Mortality at 6 months was 11% and only 36% of patients regained full recovery. There were no significant differences in the 6-month rates of mortality, unfavorable outcomes, or full recovery between TBI patients with and without concomitant isolated TSI. However, concomitant non-isolated TSI was associated with an unfavorable outcome and a higher mortality. In patients with mTBI, a negative association with full recovery could be observed for both concomitant isolated and non-isolated TSI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Rates of mortality, unfavorable outcomes, and full recovery in TBI patients with and without concomitant, isolated TSIs were comparable after 6 months. However, in patients with mTBI, concomitant TSI was a negative predictor for a full recovery. These findings might indicate that patients with moderate to severe TBI do not necessarily exhibit worse outcomes when having a concomitant TSI, whereas patients with mTBI might be more affected.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.861688","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T08:36:55Z","timestamp":1660898215000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Concomitant spine trauma in patients with traumatic brain injury: Patient characteristics and outcomes"],"prefix":"10.3389","volume":"13","author":[{"given":"Lennart","family":"Riemann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obada T.","family":"Alhalabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas W.","family":"Unterberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Younsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The CENTER-TBI investigators and participants","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/S1474-4422(18)30415-0","article-title":"Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"James","year":"2019","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss6609a1","article-title":"Traumatic brain injury-related emergency department visits, hospitalizations, and deaths - United States, 2007 and 2013","volume":"66","author":"Taylor","year":"2017","journal-title":"MMWR Surveill Summ."},{"key":"B3","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1016\/S1474-4422(08)70164-9","article-title":"Moderate and severe traumatic brain injury in adults","volume":"7","author":"Maas","year":"2008","journal-title":"Lancet Neurol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"535","DOI":"10.23736\/S0390-5616.18.04532-0","article-title":"Epidemiology of severe traumatic brain injury","volume":"62","author":"Iaccarino","year":"2018","journal-title":"J Neurosurg Sci Oct."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1016\/j.apmr.2007.11.055","article-title":"Spinal cord injury and co-occurring traumatic brain injury: assessment and incidence","volume":"89","author":"Macciocchi","year":"2008","journal-title":"Arch Phys Med Rehabil Jul."},{"key":"B6","doi-asserted-by":"publisher","first-page":"622","DOI":"10.2340\/16501977-0101","article-title":"Traumatic brain injury is under-diagnosed in patients with spinal cord injury","volume":"39","author":"Tolonen","year":"2007","journal-title":"J Rehabil Med Oct."},{"key":"B7","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1111\/j.1600-0404.2010.01376.x","article-title":"Traumatic spinal cord injury and concomitant brain injury: a cohort study","volume":"190","author":"Hagen EM Eide","year":"2010","journal-title":"Acta Neurol Scand Suppl."},{"key":"B8","doi-asserted-by":"publisher","first-page":"370","DOI":"10.2340\/16501977-1261","article-title":"Missed diagnosis of traumatic brain injury in patients with traumatic spinal cord injury","volume":"46","author":"Sharma","year":"2014","journal-title":"J Rehabil Med Apr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"E33","DOI":"10.1097\/HTR.0000000000000153","article-title":"Traumatic brain injury in spinal cord injury: frequency and risk factors","volume":"31","author":"Budisin","year":"2016","journal-title":"J Head Trauma Rehabil Jul-Aug."},{"key":"B10","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s10143-018-0988-3","article-title":"Prevalence of concomitant traumatic cranio-spinal injury: a systematic review and meta-analysis","volume":"43","author":"Pandrich","year":"2020","journal-title":"Neurosurg Rev Feb."},{"key":"B11","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3171\/spi.2002.96.3.0285","article-title":"Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics","volume":"96","author":"Holly","year":"2002","journal-title":"J Neurosurg Apr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1097\/TA.0b013e31819db57c","article-title":"Clinical characterization of comatose patients with cervical spine injury and traumatic brain injury","volume":"67","author":"Tian","year":"2009","journal-title":"J Trauma Acute Care Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1097\/01.PHM.0000104661.86307.91","article-title":"Effect of co-morbid traumatic brain injury on functional outcome of persons with spinal cord injuries","volume":"83","author":"Macciocchi","year":"2004","journal-title":"Am J Phys Med Rehabil Jan."},{"key":"B14","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1227\/NEU.0000000000000575","article-title":"Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI): a prospective longitudinal observational study","volume":"76","author":"Maas","year":"2015","journal-title":"Neurosurgery Jan."},{"key":"B15","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1016\/S1474-4422(19)30232-7","article-title":"Case-mix, care pathways, and outcomes in patients with traumatic brain injury in CENTER-TBI: a European prospective, multicentre, longitudinal, cohort study","volume":"18","author":"Steyerberg","year":"2019","journal-title":"Lancet Neurol Oct."},{"key":"B16","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1002\/bimj.4710310118","article-title":"Rubin, Donald B.: multiple imputation for nonresponse in surveys. John Wiley & Sons, Chichester \u2013 New York \u2013 Brisbane \u2013 Toronto \u2013 Singapore 1987, xxx, 258 S., 6 Abb., \u00a3 30.25, ISSN 0271-6232","volume":"31","author":"Gladitz","year":"1989","journal-title":"Biom J"},{"key":"B17","unstructured":"TeamRC\n          R: A Language Environment for Statistical Computing2021"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1016\/j.injury.2006.07.009","article-title":"AIS 2005: a contemporary injury scale","volume":"37","author":"Gennarelli","year":"2006","journal-title":"Injury Dec."},{"key":"B19","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1016\/j.injury.2009.05.013","article-title":"The impact of the AIS 2005 revision on injury severity scores and clinical outcome measures","volume":"40","author":"Salottolo","year":"2009","journal-title":"Injury Sep."},{"key":"B20","first-page":"155","article-title":"Cervical spine functional anatomy and the biomechanics of injury due to compressive loading","volume":"40","author":"Swartz","year":"2005","journal-title":"J Athl Train Jul-Sep."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2017.10.JNS17352","article-title":"Estimating the global incidence of traumatic brain injury","volume":"1","author":"Dewan","year":"2018","journal-title":"J Neurosurg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"252","DOI":"10.4103\/0974-2700.120365","article-title":"Risk factors for cervical spine injury among patients with traumatic brain injury","volume":"6","author":"Fujii","year":"2013","journal-title":"J Emerg Trauma Shock Oct."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.861688\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T08:37:03Z","timestamp":1660898223000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.861688\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,18]]},"references-count":22,"alternative-id":["10.3389\/fneur.2022.861688"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2022.861688","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,18]]},"article-number":"861688"}}