title: Upper lumbar burst fracture due to recreational high jumping into a river: report of five cases.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Gifu University School of Medicine, Gujo City Hospital, Gifu, Japan. kikukensports@ybb.ne.jp
authors.forename: Kenta
authors.initials: K
authors.lastname: Kikuike
authors.forename: Shuichi
authors.initials: S
authors.lastname: Uemura
authors.forename: Kei
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Horiya
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: 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