title: Spinal column and spinal cord injuries in mountain bikers: a 13-year review.
abstract: BACKGROUND
  Multiple studies have described in general the injuries associated with mountain biking, and detailed accounts of spine injuries sustained in hockey, gymnastics, skiing, snowboarding, rugby, and paragliding have previously been published. However, no large-scale detailed assessment of mountain biking associated spinal fractures and spinal cord injuries has previously been published.
  
  
  OBJECTIVE
  This study was undertaken to describe the patient demographics, injuries, mechanisms, treatments, outcomes, and resource requirements associated with spine injuries sustained while mountain biking.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Patients who were injured while mountain biking, and who were seen at a provincial spine referral center between 1995 and 2007 inclusive, with spinal cord injuries and/or spine fracture were included. A chart review was performed to obtain demographic data, and details of the injury, treatment, outcome, and resource requirements.
  
  
  RESULTS
  A total of 102 men and 5 women were identified for inclusion. The mean age at injury was 32.7 years (95% confidence interval 30.6, 35.0). Seventy-nine patients (73.8%) sustained cervical injuries, while the remainder sustained thoracic or lumbar injuries. Forty-three patients (40.2%) sustained a spinal cord injury. Of those with cord injuries, 18 (41.9%) were American Spinal Injury Association (ASIA) A, 5 (11.6%) were ASIA B, 10 (23.3%) ASIA C, and 10 (23.3%) ASIA D. Sixty-seven patients (62.6%) required surgical treatment. The mean length of stay in an acute hospital bed was 16.9 days (95% confidence interval 13.1, 30.0). Thirty-three patients (30.8%) required intensive care unit attention, and 31 patients (29.0%) required inpatient rehabilitation. Of the 43 patients (40.2%) seen with spinal cord injuries, 14 (32.5%) improved by 1 ASIA category, and 1 (2.3%) improved by 2 ASIA categories. Two patients remained ventilator-dependent at discharge.
  
  
  CONCLUSIONS
  Spine fractures and spinal cord injuries caused by mountain biking accidents typically affect young, male, recreational riders. The medical, personal, and societal costs of these injuries are high. Injury prevention should remain a primary goal, and further research is necessary to explore the utility of educational programs, and the effect of helmets and other protective gear on spine injuries sustained while mountain biking.
authors.affiliation: Division of Spine, University of British Columbia, Blusson Spinal Cord Centre, 818 West 10th Avenue, Vancouver, BC, Canada.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Dodwell
authors.forename: Brian K
authors.initials: BK
authors.lastname: Kwon
authors.forename: Barbara
authors.initials: B
authors.lastname: Hughes
authors.forename: David
authors.initials: D
authors.lastname: Koo
authors.forename: Andrea
authors.initials: A
authors.lastname: Townson
authors.forename: Allan
authors.initials: A
authors.lastname: Aludino
authors.forename: Richard K
authors.initials: RK
authors.lastname: Simons
authors.forename: Charles G
authors.initials: CG
authors.lastname: Fisher
authors.forename: Marcel F
authors.initials: MF
authors.lastname: Dvorak
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Noonan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001642:Bicycling / Q000293:injuries*; D001955:British Columbia / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D050723:Fractures, Bone; D006295:Health Resources; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D055815:Young Adult