Motor vehicle mismatch-related spinal injury.
OBJECTIVE
Motor vehicle collision (MVC)-related spinal cord injury (SCI) is the most prevalent etiology of SCI. Few studies have defined SCI risk factors. Vehicle mismatch occurs in 2-vehicle MVCs in which there are significant differences in vehicle weight, stiffness, and height. This study examined SCI risk and vehicle mismatch.


METHODS
A matched case-control study using the 1995 to 2003 National Automotive Sampling System (NASS). Study subjects were identified from 2-vehicle MVCs. Cases were occupants who had suffered a cervical, thoracic, or lumbar SCI. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.


RESULTS
There were 101,682 cases of SCI matched to 805,091 controls. Occupants of passenger vehicles involved in MVCs with a light truck or van (LTV) were at increased risk for SCI (OR = 1.87, 95% CI = 1.07-3.24) and this risk was greatest for thoracic SCI (OR = 5.09, 95% CI = 2.33-11.13). In addition, occupants of LTVs involved in MVCs with passenger vehicles were at significant increased risk for cervical (OR = 1.39) and lumbar (OR = 2.65) SCI; and occupants of LTVs involved in MVCs with other LTVs were at increased risk of any SCI (OR = 2.02, 95% CI = 1.52-2.69). For these subjects, significant increased risks were seen for all spine regions: cervical (OR = 1.41), thoracic (OR = 2.86), and lumbar (OR = 2.38).


CONCLUSIONS
The results of this study suggest that occupants of passenger vehicles are at increased SCI risk when involved in 2-vehicle MVCs with LTVs; and that occupants of LTVs are at increased SCI risk, regardless.
Cobb
Jason D
JD
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
MacLennan
Paul A
PA
McGwin
Gerald
G
Metzger
Jesse S
JS
Rue
Loring W
LW
D000328:Adult; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000293:injuries; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles / Q000145:classification* / Q000706:statistics & numerical data*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012449:Safety / Q000706:statistics & numerical data; D013124:Spinal Injuries / Q000145:classification* / Q000453:epidemiology / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000293:injuries