Objective: Spine trauma occurs frequently in multiple injured patients. Pre-hospital diagnosis is difficult. Clinical management depends on associated injuries and neurologic status.

To evaluate epidemiology and influence of recent therapeutic regimens on outcome we analyzed the data of the German Trauma Registry (German Trauma Society, DGU).

Methods: Out of 8057 patients in the German Trauma Registry 772 patients (28 % women, 72 % men; mean age 37 +/− 17 yrs.; mean ISS: 29 +/− 15 (range 9–75) points) with severe spine trauma (AIS> 2) were investigated in a retrospective analysis.

Results: MVAs were the most frequent cause for severe spine trauma (49%). The age group 25–34 years was most affected (26%). About half of all severe spine injuries were not expected in the prehospital setting. Neurologic deficit was observed in 47%. 41% of the patients with severe C-spine lesion had an initial GCS < 9 points. 89% of the patients had no preexisting comorbidity. Mortality rate (90 days) amounted to 22%. Sepsis occurred in 9%. Respiratory failure was the most common organ dysfunction (18%). Median ICU stay was 8 days. Thoracic spine lesions were almost always associated with thoracic trauma (96%; other locations 37%). Lumbar spine injuries were highly related to abdominal injuries (93%).

Conclusion: Almost 10% of all documented cases in the German Trauma Registry showed severe vertebral injuries. The extend of injury was often underestimated in the preclinical setting. Due to the high incidence of thoracic injuries in thoracic spine trauma a well balanced surgical and critical care regimen is warranted especially in this group.