Spinal trauma related to military combat: characteristics, mechanisms of injury and principles of management

Trauma-related spinal injuries have been reported as far back as Egyptian times when their severity was recognized but treatment limited and outcomes poor. Advances in the knowledge and management of these injuries have arisen due to increased periods of conflict in the 20th and 21st centuries. With terrorist activity increasing globally, clinicians working in the civilian environment are increasingly being called upon to manage severe, high-energy injuries of the sort usually seen in conflict. This review considers the differences in the mechanism, pattern, and management of spinal trauma in a military combat setting to allow translation to a civilian setting.