What question did this study set out to answer?

This research aims to explore the relationship between traumatic brain injury and concomitant spinal injuries, focusing on epidemiology and patient outcomes.

February 20, 2026Open Access

The Burden of Concomitant Spinal Injury in the Setting of Traumatic Brain Injury that Required Admission to ICU—Lessons from a Tertiary Neurosurgery Center

Key Points

This research aims to explore the relationship between traumatic brain injury and concomitant spinal injuries, focusing on epidemiology and patient outcomes.
Developed a database from ICU admissions over 12 years.
Analyzed electronic patient records for demographics, mechanisms of injury, and outcomes.
Identified patients with both TBI and spinal column or cord injuries.
15.2% of ICU patients with TBI had concomitant spinal injuries.
Higher occurrence of thoracolumbar injuries compared to cervical spine injuries.
2.9% of patients had spinal cord injuries.
Severe TBI correlated with spinal injuries, with 20% mortality during admission.

Abstract

Abstract Introduction While individually both traumatic brain injury (TBI) and traumatic spinal injury have been studied extensively, the relationship between concurrent TBI and spinal column and/or cord injuries has not. We aimed to identify basic epidemiology, patterns of injury, and patient outcomes from a population served by a tertiary neurosurgery center. Methodology A database was built of patient data on admissions to an adult intensive care unit with a TBI over a 12-year period. Electronic patient records, sourced from the database of the Scottish Intensive Care Society Audit Group (SICSAG), were analyzed retrospectively to identify patients who had suffered both a TBI and a concomitant spinal column/cord injury. Data were analyzed on demographics, mechanism of injury, neurological parameters on arrival, clinical management, discharge destinations, and patient outcomes. Results Out of 560 patients admitted to ICU with TBI, 85 (85/560; 15.2%) were found to have concomitant spinal injuries. Concomitant thoracolumbar spinal injuries (34/85) were more common than cervical spine injuries (30/85), with 21 patients sustaining both cervical and thoracolumbar injuries. Among the concomitant brain and spinal trauma, spinal cord injuries (SCI) were identified in 16/85 patients (16/560; 2.9%). Outcome assessment revealed 18/85 mortality during index admission, while 36/85 patients required further neurorehabilitation. Concomitant spinal injury was associated with more severe TBI, with 60/85 patients having GCS ≤ 8, and poorer outcomes, with 20% of patients dying during admission. Dichotomizing between cervical and thoracolumbar regions, more SCIs occurred in cervical (10/85) than thoracolumbar (6/85) trauma. SCIs were more pronounced if GCS ≤ 8. Conclusions Among TBI requiring ICU admission, there were 15.2% concomitant spinal column injuries, including 2.9% SCI. Lessons on the patterns of concomitant craniospinal injury and their outcomes can help stratify resources, improve the assessment and diagnosis of such complex trauma, and guide future protocols to improve patient outcomes.

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