Motor vehicle crashes and spinal injury

Wigglesworth, E. C.

doi:10.1038/sc.1992.112

Cited by 11 publications

(11 citation statements)

References 4 publications

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“…The high male:female ratio found in the present study was also described in previous studies on SCI 2,3,14,18 as well as in the Israeli Trauma Registration of people injured in road accidents. The gender ratio was higher in SCI than in other road accident victims, probably because of the higher proportion of car and motorcycle riders (who are mainly men) in the first group.…”

Section: Gendersupporting

confidence: 69%

“…In Thailand and Australia, they cause about 50% of SCIs. 14,15 An Australian study showed an increase in SCI following road accidents, probably because of the increased rate of seat belts usage, which prevented death but not SCI.…”

Section: Discussionmentioning

confidence: 99%

“…The gender ratio was higher in SCI than in other road accident victims, probably because of the higher proportion of car and motorcycle riders (who are mainly men) in the first group. 14 …”

Section: Gendermentioning

confidence: 99%

“…13 An Australian study, which did not include pedestrians, showed similar SCI involvement in road accident patients to this study. 14 In the Australian study, the risk of SCI was higher among motorcycle riders than among car drivers and passengers.…”

mentioning

confidence: 99%

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Survival, neurological recovery and morbidity after spinal cord injuries following road accidents in Israel

et al. 2007

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Design: A retrospective cohort study. Objective: Assess outcomes in patients with spinal cord injuries (SCI) following road accidents, and factors that affect them. Setting: Loewenstein Rehabilitation Hospital, Raanana, Israel. Subjects: A total of 143 patients admitted for rehabilitation between 1962 and 2004. Methods: Survival rates were estimated using the product limit (Kaplan-Meyer) method and their association with risk factors was analyzed with the Cox model. Neurological recovery was determined by comparing the Frankel grade at admission to rehabilitation and at discharge. The relation between recovery and various factors was tested with logistic regression. Results: The risk of SCI in road accidents is higher among car drivers and motorcycle or bicycle riders. Median survival was 43 years. Survival was negatively associated with age at injury (Po0.0002) and with diagnosis of pressure sores (P ¼ 0.0065). Recovery of at least one Frankel grade occurred in 29.1% of patients. Useful recovery (upgrade to Frankel grade D or E) occurred in 23.1% of all patients. Neurological recovery was negatively associated with the severity of neurological deficit (Po0.001) and with thoracic injuries (P ¼ 0.046). The most common complications were pressure sores and those of the urinary and respiratory systems. Conclusions: In SCI following road accidents, survival rates were higher and recovery rates lower than in mixed types of trauma. This may be related to better compensation followed by better nursing for road accident victims in Israel, which may prevent life-shortening complications, and to more severe injuries caused by road accidents.

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Section: Gendersupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

“…The gender ratio was higher in SCI than in other road accident victims, probably because of the higher proportion of car and motorcycle riders (who are mainly men) in the first group. 14 …”

Section: Gendermentioning

confidence: 99%

mentioning

confidence: 99%

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Survival, neurological recovery and morbidity after spinal cord injuries following road accidents in Israel

et al. 2007

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“…27 Several authors previously investigated factors that predispose to SCI after an MVC. 3,28,40,44,47 These previous studies were generally based on subsets of data from a single institution or state and frequently included injuries sustained not just by vehicle occupants but also by pedestrians and motorcycle riders involved in the collision, who are subject to different mechanisms of injury. 3,29,44 Some authors reported an increased risk of SCI after rollover collisions compared with that after collisions without vehicle rollover, after single-vehicle collisions compared with that after multiple-vehicle collisions, and in occupants of sports utility vehicles compared with those in sedans.…”

mentioning

confidence: 99%

Incidence and mechanism of neurological deficit after thoracolumbar fractures sustained in motor vehicle collisions

Mukherjee¹,

Beck²,

Yoganandan

et al. 2016

SPI

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OBJECT To determine the incidence of and assess the risk factors associated with neurological injury in motor vehicle occupants who sustain fractures of the thoracolumbar spine. METHODS In this study, the authors queried medical, vehicle, and crash data elements from the Crash Injury Research and Engineering Network (CIREN), a prospectively gathered multicenter database compiled from Level I trauma centers. Subjects had fractures involving the T1–L5 vertebral segments, an Abbreviated Injury Scale (AIS) score of ≥ 3, or injury to 2 body regions with an AIS score of ≥ 2 in each region. Demographic parameters obtained for all subjects included age, sex, height, body weight, and body mass index. Clinical parameters obtained included the level of the injured vertebra and the level and type of spinal cord injury. Vehicular crash data included vehicle make, seatbelt type, and usage and appropriate use of the seatbelt. Crash data parameters included the principal direction of force, change in velocity on impact (ΔV), airbag deployment, and vehicle rollover. The authors performed a univariate analysis of the incidence and the odds of sustaining spinal neurological injury associated with major thoracolumbar fractures with respect to the demographic, clinical, and crash parameters. RESULTS Neurological deficit associated with thoracolumbar fracture was most frequent at extremes of age; the highest rates were in the 0- to 10-year (26.7% [4 of 15]) and 70- to 80-year (18.4% [7 of 38]) age groups. Underweight occupants (OR 3.52 [CI 1.055–11.7]) and obese occupants (OR 3.27 [CI 1.28–8.31]) both had higher odds of sustaining spinal cord injury than occupants with a normal body mass index. The highest risk of neurological injury existed in crashes in which airbags deployed and the occupant was not restrained by a seatbelt (OR 2.35 [CI 0.087–1.62]). Reduction in the risk of neurological injuries occurred when 3-point seatbelts were used correctly in conjunction with the deployment of airbags (OR 0.34 [CI 1.3–6.6]) compared with the occupants who were not restrained by a seatbelt and for whom airbags were not deployed. Crashes with a ΔV greater than 50 km/hour had a significantly higher risk of spinal cord injury (OR 3.45 [CI 0.136–0.617]) than those at lower ΔV values. CONCLUSIONS Deployment of airbags was protective against neurological injury only when used in conjunction with 3-point seatbelts. Vehicle occupants who were either obese or underweight, very young or elderly, and those in crashes with a ΔV greater than 50 km/hour were at higher risk of thoracolumbar neurological injury. Neurological injury at thoracic and lumbar levels was associated with multiple factors, including the incidence of fatality, occupant factors such as age and body habitus, energy at impact, and direction of impact. Current vehicle safety technologies are geared toward a normative body morphology and need to be reevaluated for various body morphologies and torso compliances to lower the risk of neurological injury resulting from thoracolumbar fractures.

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Spinal cord injury: aetiology, incidence and impairments

Hammell¹

1995

Spinal Cord Injury Rehabilitation

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Motor vehicle crashes and spinal injury

Cited by 11 publications

References 4 publications

Survival, neurological recovery and morbidity after spinal cord injuries following road accidents in Israel

Survival, neurological recovery and morbidity after spinal cord injuries following road accidents in Israel

Incidence and mechanism of neurological deficit after thoracolumbar fractures sustained in motor vehicle collisions

Spinal cord injury: aetiology, incidence and impairments

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