title: Spinal fracture-dislocations and spinal cord injuries in motor vehicle crashes.
abstract: OBJECTIVE
  This study estimated the annual count of spinal cord injuries (SCIs) in motor vehicles crashes by type and seat belt use using 18 years of NASS-CDS data. It determined the rate for SCI and fracture-dislocation of the spine.
  
  
  METHODS
  1994-2011 NASS-CDS was used to estimate the annual occurrence of spinal injuries in front seat occupants involved in motor vehicle crashes. Crashes were grouped by front, side, rear, and rollovers, and the effects of belt use were investigated. Light vehicles were included with model year 1994+. Spinal injuries were classified as minor (Abbreviated Injury Scale [AIS] 1), moderate (AIS 2), serious (AIS 3), fracture-dislocations, and SCI (AIS 4+). The annual count and rate for different types of spinal injury were estimated along with standard errors. The results were compared to estimates of head injuries. NASS-CDS electronic cases of SCIs in rear impacts were investigated.
  
  
  RESULTS
  There were 5,592 ± 1,170 fracture-dislocations of the spine and 1,046 ± 193 AIS 4+ SCI per year in motor vehicle crashes. Most of the injuries occurred in rollovers and frontal crashes and the least occurred in rear impacts. The rate of SCI was 0.054 ± 0.010%. The highest rate was 0.220 ± 0.056% in rollover crashes and the lowest rate was 0.032 ± 0.009% in frontal crashes. The highest rate for spinal fracture-dislocation was 1.552 ± 0.455% in rollovers and the lowest was 0.065 ± 0.021% in rear impacts. The rate for SCI was 0.027 ± 0.005% in belted and 0.145 ± 0.028% in unbelted occupants giving 81% effectiveness of belt use in reducing SCI. The cervical spine was associated with 66.3 ± 11.3% of the AIS 4+ SCI with 30.5 ± 7.4% in the thoracic spine and 3.2 ± 1.3% in the lumbar spine. Severe head injuries occurred 13.3 times more often than SCIs.
  
  
  CONCLUSIONS
  Spinal cord injury occurred in one out of 1,860 front seat occupants in tow-away crashes. The rate was highest in rollover crashes and was reduced by seat belt use. Fracture-dislocation of the spine occurred about 5.3 times more often than SCIs and was also prevented by seat belt use.
authors.affiliation: a ProBiomechanics LLC , Bloomfield Hills , Michigan.
authors.forename: Chantal S
authors.initials: CS
authors.lastname: Parenteau
authors.forename: David C
authors.initials: DC
authors.lastname: Viano
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D016208:Databases, Factual; D006801:Humans; D004204:Joint Dislocations / Q000453:epidemiology*; D011446:Prospective Studies; D012622:Seat Belts / Q000706:statistics & numerical data*; D013119:Spinal Cord Injuries / Q000453:epidemiology*; D016103:Spinal Fractures / Q000453:epidemiology*; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology
keywords: dislocations; fracture; motor vehicle crashes; restraint effectiveness; seat belts; spinal cord injury