Original research

Isolated vertebral fractures give elevated serum protein S-100B levels

Lorin M Benneker² , Christoph Leitner¹ , Luca Martinolli¹ , Kretschmer Robert³ , Heinz Zimmermann¹ and Aristomenis K Exadaktylos¹

¹  Department of Emergency Medicine, Bern University Hospital, Switzerland

²  Department of Orthopaedic and Trauma Surgery, Bern University Hospital, Switzerland

³  Department of Analytical Chemistry, Bern University Hospital Switzerland

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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2008, 16:13doi:10.1186/1757-7241-16-13

Published:	7 November 2008

Abstract

Background

Serum protein S-100B determinations have been widely proposed in the past as markers of traumatic brain injury and used as a predictor of injury severity and outcome. The purpose of this prospective observational case series was therefore to determine S-100B serum levels in patients with isolated injuries to the back.

Methods

Between 1 February and 1 May 2008, serum samples for S-100B analysis were obtained within 1 hour of injury from 285 trauma patients. All patients with a head injury, polytrauma, and intoxicated patients were excluded to select isolated injuries to the spine. 19 patients with isolated injury of the back were included. Serum samples for S-100B analysis and CT spine were obtained within 1 hours of injury.

Results

CT scans showed vertebral fractures in 12 of the 19 patients (63%). All patients with fractures had elevated S-100B levels. Amongst the remaining 7 patients without a fracture, only one patient with a severe spinal contusion had an S-100B concentration above the reference limit. The mean S-100B value of the group with fractures was more than 4 times higher than in the group without fractures (0.385 vs 0.087 μg/L, p = 0.0097).

Conclusion

Our data, although limited due to a very small sample size, suggest that S-100B serum levels might be useful for the diagnosis of acute vertebral body and spinal cord injury with a high negative predictive power. According to the literature, the highest levels of serum S-100B are found when large bones are fractured. If a large prospective study confirms our findings, determining the S-100B level may contribute to more selective use of CT and MRI in spinal trauma.