Spinal injuries in motorcycle crashes: patterns and outcomes.
BACKGROUND
The purpose of this study was to determine patterns of spinal injury and clinical outcomes resulting from motorcycle crashes.


METHODS
We analyzed data collected on 1,121 motorcyclists involved in road traffic accidents (from 1993-2000) and identified those who had sustained a spinal injury.


RESULTS
Spinal injury occurred in 126 (11.2%) riders (112 male riders [88.9%] and 14 female riders [11.1%]), with a mean age of 30.2 years (range, 16-61 years) and Injury Severity Score of 18.8 (range, 4-66). Isolated injuries to the spine occurred in 30 (23.8%) riders. The thoracic spine was injured in 69 (54.8%), the lumbar spine in 37 (29.4%), and the cervical spine in 34 (27.0%) cases. Multiple vertebral levels were affected in 54 (42.9%). Neurologic injury occurred in 25 riders (19.8%), with complete distal neurologic injury in 14 (4 cervical, 9 thoracic, and 1 lumbar). Eleven (8.7%) patients required spinal surgery. There were 13 (10.3%) deaths.


CONCLUSIONS
The thoracic spine is the most commonly injured spinal region in motorcycle crashes. Multiple level injuries are common. Protocols concentrating on the radiographic clearance of the cervical region may miss a significant number of spinal injuries. Vigilance is required in assessing these patients, who often have multiple injuries.
Department of Trauma and Orthopaedic Surgery, St. James's University Hospital, Leeds, West Yorkshire, United Kingdom.
Angus
A
Robertson
Peter V
PV
Giannoudis
Toby
T
Branfoot
Ian
I
Barlow
Stuart J
SJ
Matthews
Raymond M
RM
Smith
D000063:Accidents, Traffic / Q000401:mortality / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D004638:Emergency Treatment / Q000592:standards; D004739:England / Q000453:epidemiology; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009049:Motorcycles / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013124:Spinal Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome