The nature of damage to the structure of the spine and spinal cord in combined blunt trauma

Background. Vertebral-spinal injuries (VSIs) account for 6.3–26% of skeletal injuries. However, despite the relevance of VSIs in all branches of medicine, the forensic aspects of this injury are insufficiently assessed. Material and methods. The study included three groups: people who died following multiple injuries from falling from a height (82 cases); those who died following collision with moving cars (172 cases); and drivers of passenger cars who died in road accidents (61 cases). Results. The article describes in detail the results of the analysis. As part of combined injury during falls, VSI was observed in 41.5% of cases with lesions of other body parts and often covering 2 or more parts of the spine, and in terms of localization, most often in the lower neck, upper chest, and lumbar regions. Compression fractures were often noted, which resulted from falls on the legs and buttocks. In pedestrians who were injured in collisions with cars, VSI was noted in 25% cases; of these, most cases involved distraction and rotational fractures of the vertebral bodies, with detachments at the level of vertebral fractures prevailing primarily with mainly trauma of the posterior processes. Injuries to the spine structure often included cervical -occipital trauma and damage to the cervical region, as well as combined injuries to the cervical-thoracic regions; VSI in affected drivers was noted in 14.5% cases and was characterized by cervical-occipital trauma as well as lesions of the cervical, upper thoracic, and lumbar vertebrae. Сonclusion: The revealed nature of damage to the noted structures should be taken into account in the process of forensic medical diagnosis and differential diagnosis of blunt injuries, especially in conditions of non-obviousness of the circumstances of the damage. The nature, volume and localization of injuries arising from these types of blunt mechanical trauma can be important in the process of organizing and providing medical care to victims at various stages of treatment, and information on the circumstances of the origin of injuries can become the basis for developing preventive measures to prevent injuries.