RT Journal Article
SR Electronic
T1 Elevated serum S100B levels in acute spinal fracture without head injury
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 209
OP 212
DO 10.1136/emj.2008.063743
VO 27
IS 3
A1 Sang Jin Lee
A1 Chan Woong Kim
A1 Kwang Jung Lee
A1 Ju Won Choe
A1 Sung Eun Kim
A1 Je Hyeok Oh
A1 Yong Soon Park
YR 2010
UL http://emj.bmj.com/content/27/3/209.abstract
AB Background S100B is a biomarker that reflects injury to the central nervous system. As the spine is an integral part of the spinal cord, a study was undertaken to investigate whether serum S100B levels are associated with acute spinal fracture without head injury.Methods The study population consisted of 32 consecutive patients aged ≥18 years in whom the emergency physicians suspected spinal fractures. All the patients underwent CT scans to establish the diagnosis of spinal fracture. MRI was then performed on all the patients to determine the presence of spinal cord injury.Results Serum S100B levels were higher in the spinal fracture group than in the non-spinal fracture group, and 19 of the 20 patients in the spinal fracture group (95%) had an S100B level >0.12 μg/l, whereas all 12 of the non-spinal fracture group had an S100B level ≤0.12 μg/l. The S100B level in patients with epidural encroachment of the spinal cord was significantly higher (0.22–4.58 μg/l; mean 2.45 μg/l; 95% CI 0.95 to 3.94) than in those without epidural encroachment (0.114–2.87 μg/l; mean 0.80 μg/l; 95% CI 0.24 to 1.37) (p=0.037). Plain radiography revealed no definite abnormal findings in half of the patients with spinal fracture.Conclusions Serum S100B levels are raised in all patients with acute spinal fracture without head injury. Spinal fracture may therefore be one of the extracerebral sources of S100B. Serum S100B levels may be an effective tool for excluding subtle spinal fractures with no clear radiographic findings.