title: Biomechanical modelling of impact-related fracture characteristics and injury patterns of the cervical spine associated with riding accidents.
abstract: BACKGROUND
  Horse-related injuries are manifold and can involve the upper and lower limbs, the trunk, spine or head. Cervical spine injuries are not among the most common injuries. However, they can be fatal and often result in neurological symptoms. This study investigated the influence of the posture of the cervical spine on the ultimate strength and the pattern of vertebrae failure with the aim to provide some guidance for protective clothing design.
  
  
  METHODS
  Eighteen human cervical spines, each divided into two specimens (three vertebrae each), were subjected to a simulator test designed to mimic a spinal trauma in different postures of the specimen (neutral, flexion, extension). The stress-to-failure, the deformation at the time of fracture and the fracture patterns assessed based on CT scans were analysed.
  
  
  RESULTS
  Stress-to-failure of the superior specimens was lower for the flexion group compared to the others (P=0.027). The superior specimens demonstrated higher stress-to-failure in comparison to the inferior specimens (P<0.001). Compression in a neutral or flexed position generated mild or moderate fracture patterns. On the contrary, the placement of the spine in extension resulted in severe fractures mostly associated with narrowing of the spinal canal.
  
  
  CONCLUSIONS
  The results imply that a neutral cervical spine position during an impaction can be beneficial. In this position, the failure loads are high, and even if a vertebral fracture occurs, the generated injury patterns are expected to be mild or moderate.
authors.affiliation: Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestr. 15, 21073 Hamburg, Germany; Centre for Orthopaedic Biomechanics, University of Bath, Claverton Down, Bath BA2 7AY, United Kingdom. Electronic address: sabrina.jauch@tuhh.de.
authors.forename: S Y
authors.initials: SY
authors.lastname: Jauch
authors.affiliation: Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestr. 15, 21073 Hamburg, Germany; Department of Trauma and Reconstructive Surgery, BG Trauma Hospital, Bergedorfer Straße 10, 21033 Hamburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wallstabe
authors.affiliation: Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestr. 15, 21073 Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Sellenschloh
authors.affiliation: Department of Trauma and Reconstructive Surgery, BG Trauma Hospital, Bergedorfer Straße 10, 21033 Hamburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Rundt
authors.affiliation: Department of Legal Medicine, UKE University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Püschel
authors.affiliation: Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestr. 15, 21073 Hamburg, Germany.
authors.forename: M M
authors.initials: MM
authors.lastname: Morlock
authors.affiliation: Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Lohmühlenstraße 5, 20099 Hamburg, Germany.
authors.forename: N M
authors.initials: NM
authors.lastname: Meenen
authors.affiliation: Institute of Biomechanics, TUHH Hamburg University of Technology, Denickestr. 15, 21073 Hamburg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Huber
mesh_terms: D000059:Accidents; D000293:Adolescent; D000328:Adult; D000818:Animals; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006736:Horses; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D016059:Range of Motion, Articular; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Cervical spine injury; Fracture pattern; Horse-related accident; Posture; Ultimate strength