title: Motorcycle helmets associated with lower risk of cervical spine injury: debunking the myth.
abstract: BACKGROUND
  There has been a repeal of the universal helmet law in several states despite definitive evidence that helmets reduce mortality, traumatic brain injury, and hospital expenditures. Opponents of the universal helmet law have successfully claimed that helmets should not be required because of greater torque on the neck, which is thought to increase the likelihood of a cervical spine injury. There is currently insufficient evidence to counter claims that helmets do not increase the risk of cervical spine injury after a motorcycle collision. The objective of this study was to determine the impact of motorcycle helmets on the likelihood of developing a cervical spine injury after a motorcycle collision.
  
  
  METHODS
  We reviewed cases in the National Trauma Databank (NTDB) v7.0 involving motorcycle collisions. Multiple logistic regression was used to analyze the independent effect of helmets on cervical spine injury. Cases were adjusted for age, race, sex, insurance status, anatomic (Injury Severity Score) and physiologic injury severity (systolic blood pressure < 90 mmHg), and head injury (Abbreviated Injury Score > 3).
  
  
  RESULTS
  Between 2002 and 2006, 62,840 cases of motorcycle collision were entered into the NTDB; 40,588 had complete data and were included in the adjusted analysis. Helmeted riders had a lower adjusted odds (0.80 [CI 0.72 to 0.90]) and a lower proportion of cervical spine injury (3.5% vs 4.4%, p < 0.05) compared with nonhelmeted riders.
  
  
  CONCLUSIONS
  Helmeted motorcyclists are less likely to suffer a cervical spine injury after a motorcycle collision. This finding challenges a long-standing objection to mandatory helmet use that claims helmets are associated with cervical spine injury. Re-enactment of the universal helmet law should be considered in states where it has been repealed.
authors.affiliation: Department of Surgery, University of California-Los Angeles, School of Medicine, Los Angeles, CA, USA. jcrompton@mednet.ucla.edu
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Crompton
authors.forename: Curt
authors.initials: C
authors.lastname: Bone
authors.forename: Tolulope
authors.initials: T
authors.lastname: Oyetunji
authors.forename: Keshia M
authors.initials: KM
authors.lastname: Pollack
authors.forename: Oluwaseyi
authors.initials: O
authors.lastname: Bolorunduro
authors.forename: Cassandra
authors.initials: C
authors.lastname: Villegas
authors.forename: Kent
authors.initials: K
authors.lastname: Stevens
authors.forename: Edward E
authors.initials: EE
authors.lastname: Cornwell
authors.forename: David T
authors.initials: DT
authors.lastname: Efron
authors.forename: Elliott R
authors.initials: ER
authors.lastname: Haut
authors.forename: Adil H
authors.initials: AH
authors.lastname: Haider
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries*; D006259:Craniocerebral Trauma / Q000517:prevention & control; D016208:Databases, Factual; D005260:Female; D006260:Head Protective Devices / Q000009:adverse effects*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000209:etiology*