Upper lumbar burst fracture due to recreational high jumping into a river: report of five cases.
BACKGROUND
Spinal injuries resulting from entering into water usually occur in the cervical region, with few reported in the thoracolumbar region. Although the mechanism of cervical spine injury caused by diving is known, less is known regarding the mechanism of upper lumbar spine injury.


METHODS
The study subjects were five patients (mean age, 32.8 years), inexperienced in diving from heights, who were referred for burst fractures (Denis type B) at L1 caused while jumping into a river from a 12-m-high bridge between 2004 and 2005. Three patients were treated surgically and two were treated conservatively. Their clinical outcomes were reviewed and the mechanism of upper lumbar spine injury was discussed.


RESULTS
No patient experienced neurological deficit or low back pain after treatment, and all returned to their previous activities within 1 year. Impact with the surface of the river with back and hip flexed may be a major cause of upper lumbar spine injury.


CONCLUSIONS
To minimize the incidence of upper lumbar burst fracture during recreational high jumping into water, it is important that jumpers, especially inexperienced jumpers, should be instructed to jump with their backs and hips straight.
Kikuike
Kenta
K
Department of Orthopaedic Surgery, Gifu University School of Medicine, Gujo City Hospital, Gifu, Japan. kikukensports@ybb.ne.jp
Uemura
Shuichi
S
Miyamoto
Kei
K
Horiya
Yoshihiro
Y
Shimizu
Katsuji
K
D000328:Adult; D004242:Diving / Q000009:adverse effects*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000209:etiology* / Q000503:physiopathology