title: Cervical spine injury and restraint system use in motor vehicle collisions.
abstract: BACKGROUND
  Cervical spine injury related to motor vehicle collision (MVC) is a severe and often permanently disabling injury. Although advances in automobile crashworthiness have reduced both fatalities and some severe injuries, the impact of varying occupant restraint systems (seatbelts and airbags) on cervical spine injury is unknown.
  
  
  OBJECTIVE
  To investigate the relationship between the occurrence of cervical spine injury and occupant restraint systems among front seat occupants involved in frontal MVCs.
  
  
  METHODS
  A case-control study among subjects obtained from the 1995 to 2001 National Automotive Sampling System (NASS). Cases were identified based on having sustained a cervical spine injury score of 2 or more on the Abbreviated Injury Scale, 1990 Revision.
  
  
  RESULTS
  Approximately half (44.7%) of 8,412 cases of cervical spine injury were unrestrained occupants while belted only, airbag only, and both restraint systems represented 38.2%, 8.8%, and 8.4% of cases, respectively. Overall, the combined use of airbag and seatbelt had the greatest protective effect, relative to unrestrained occupants, with an odds ratio (OR) of 0.19 and a 95% confidence interval (CI) of 0.12 to 0.30. Use of a seatbelt only also had a protective effect (OR: 0.40; 95% CI: 0.23-0.70). Occupant use of an airbag only neither increased nor decreased the risk of cervical spine injuries relative to unrestrained occupants (OR: 1.02; 95% CI: 0.57-2.13).
  
  
  CONCLUSIONS
  The results of this study suggest that there is an increase in overall protection against cervical spine injury by combining airbag and seatbelt restraint systems relative to seatbelt alone.
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294-0009, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Claytor
authors.forename: Paul A
authors.initials: PA
authors.lastname: MacLennan
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Loring W
authors.initials: LW
authors.lastname: Rue
authors.forename: John S
authors.initials: JS
authors.lastname: Kirkpatrick
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D016208:Databases, Factual; D006801:Humans; D018986:Motor Vehicles / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011482:Protective Devices / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D013124:Spinal Injuries / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology