Characterization of all-terrain vehicle-related thoracolumbar spine injury patterns in children using the AOSpine classification system

Jordan, Roger W.; Beckmann, Nicholas M.; Johnston, Jennifer H.; Johnston, Sean; Zhang, Xu; Chinapuvvula, Naga Ramesh

doi:10.1007/s10140-020-01762-9

Cited by 3 publications

(5 citation statements)

References 28 publications

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“…The authors postulated that the discrepancy found between these age groups was due to the more adult-like spine characteristics seen in those older than 16 years such as decreased ligament laxity, more vertical facets, and absence of growth centers. Jordan et al 7) also reported that 86.1% had multiple levels of fracture, with most at contiguous levels. Of the four translational injuries observed in this cohort, 3 of the 4 occurred at the thoracolumbar junction.…”

Section: Discussionmentioning

confidence: 96%

“…ATV roll over, one of the most common mechanisms of ATV-related injury, is associated with a significant increased chance of spine fracture. 7) Hence, the contemplation of how to reduce injuries is challenging given restraints might not assist the passenger in rollover scenarios, or could even cause more harm. Sawyer et al 16) echoed the notion of very high prevalence of spinal injuries secondary to ATV accidents finding that among 208 patient admissions for ATV-related spinal injuries, 93% had spinal fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, although spine fractures comprise 1-2% of pediatric fractures, they occur in up to 7% of ATV-related injury to KID, indicative of the high energy nature of ATV accidents. 15) Jordan et al 7) also conducted a retrospective study on 456 pediatric ATV-related injuries, utilizing the AOSpine classification system. They found that 36 patients had one or more thoracolumbar spine fractures (7.9%), in which A0 (nonstructural injury) like transverse process or spinous process fracture were the most common, followed by A1 wedge compression fracture.…”

Section: Discussionmentioning

confidence: 99%

“…They found that 36 patients had one or more thoracolumbar spine fractures (7.9%), in which A0 (nonstructural injury) like transverse process or spinous process fracture were the most common, followed by A1 wedge compression fracture. 7) Sanfilippo et al 14) reviewed a database of 8,020 spine consults from 1993–2007 and found that among 32 of 36 spinal injuries related to ATV accidents, 16 (50%) were axial compression or burst fracture.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic Spinal Injury Associated with All-Terrain Vehicle (ATV) Accidents: A 10-Year Retrospective Analysis of the Coachella Valley

Houston

Cathel

Pennington

et al. 2021

Korean J Neurotrauma

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Objective The use of all-terrain vehicles (ATVs) and associated injuries have significantly increased in the last decade. This study aimed to determine the frequency of ATV-associated spinal cord injuries (SCIs) in the Coachella Valley, California, and provide recommendations for data reproducibility in other areas with a similarly substantial level of ATV usage and injuries. Methods This retrospective analysis included data obtained through screening the trauma database of a level II trauma center for ATV-related injuries between January 1, 2010 and January 1, 2020. Results Our data suggest that more than one-third of patients admitted to the trauma center over a 10-year period suffered from spinal injury. Injuries to the spine were further categorized as including the spinal cord (radiographically or clinically) or only including the bony or ligamentous elements of the spine. Injury was more common in men and predominantly located in the thoracic spine. Injuries such as epidural hematoma, vertebral artery, and cord contusion were common, with many patients requiring neurosurgical intervention. Conclusion Highlighting the implicit dangers of ATV accidents on the spine could help identify outcomes and variables predictive of spinal injuries and spinal cord injuries necessary for patient management. Additionally, our study sets the framework by which legislating bodies could replicate the study for proper legislation and recommendations that may help prevent such injuries.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Traumatic Spinal Injury Associated with All-Terrain Vehicle (ATV) Accidents: A 10-Year Retrospective Analysis of the Coachella Valley

Houston

Cathel

Pennington

et al. 2021

Korean J Neurotrauma

View full text Add to dashboard Cite

show abstract

“…In addition, some experts suggest that both scores require modification before being safely used in pediatric populations 53 . For example, in patients younger than 8 years, there is increased ligamentous laxity and decreased facet joint stability, which can result in SCIWORA 8,57 . Though these injuries are fortunately rare in the lumbar spine 58,59 , the Denis, TLICS, and TL AOSIS classification systems may all underestimate the severity of these injuries as they place significant emphasis on the fracture pattern.…”

Section: Classificationmentioning

confidence: 99%

Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients

Bonsignore-Opp,

O'Donnell,

Agha

et al. 2024

JBJS Reviews

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» Pediatric thoracolumbar trauma, though rare, is an important cause of morbidity and mortality and necessitates early, accurate diagnosis and management.» Obtaining a detailed history and physical examination in the pediatric population can be difficult. Therefore, the threshold for advanced imaging, such as magnetic resonance imaging, is low and should be performed in patients with head injuries, altered mental status, inability to cooperate with examination, and fractures involving more than 1 column of the spine.» The classification of pediatric thoracolumbar trauma is based primarily on adult studies and there is little high-level evidence examining validity and accuracy in pediatric populations.» Injury pattern and neurologic status of the patient are the most important factors when determining whether to proceed with operative management.

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Pediatric spinal injury patterns and management in all-terrain vehicle and dirt bike crashes, 2010–2019

Allen

Yengo‐Kahn²,

Cools³

et al. 2022

Journal of Neurosurgery: Pediatrics

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OBJECTIVE Pediatric spinal injuries in all-terrain vehicle (ATV) and dirt bike crashes are relatively uncommon but may be associated with significant morbidity. There are no recent studies examining these injuries, their management, and outcomes. Therefore, a retrospective study was performed to characterize pediatric spinal injuries related to ATV and dirt bike crashes over the last decade. METHODS Data on all patients involved in ATV or dirt bike crashes evaluated at a regional level 1 pediatric trauma center over a 10-year period (2010–2019) were analyzed. Descriptive statistics were analyzed and chi-square, Fisher exact, and Mann-Whitney U-tests were performed comparing the demographics, injury characteristics, and clinical outcomes in patients with versus those without spinal injuries. RESULTS Of 680 patients evaluated, 35 (5.1%) were diagnosed with spinal injuries. Over the study period, both spinal injuries and emergency department visits related to ATV or dirt bike crashes increased in frequency. All spinal injuries were initially diagnosed on CT scans, and 57.9% underwent spinal MRI. Injuries were most commonly thoracic (50%), followed by cervical (36.8%). The injuries of most patients were classified as American Spinal Injury Association (ASIA) grade E on presentation (86.8%), while 2 (5.3%) had complete spinal cord injuries (ASIA grade A) and 3 patients (8.6%) were ASIA grade B–D. Operative management was required for 13 patients (28.9%). Nonoperative management was used in 71.1% of injuries, including bracing in 33% of all injuries. Patients with spinal injuries were older than those without (13.4 ± 3.35 vs 11.5 ± 3.79 years, p = 0.003). Spinal injuries occurred via similar crash mechanisms (p = 0.48) and in similar locations (p = 0.29) to nonspinal injuries. Patients with spinal injuries more frequently required admission to the intensive care unit (ICU; 34.2% vs 14.6%, p = 0.011) and had longer hospital stays (mean 4.7 ± 5.5 vs 2.7 ± 4.0 days, p = 0.0025). CONCLUSIONS Although infrequent among young ATV and dirt bike riders, spinal injuries are associated with longer hospital stays, increased ICU use, and required operative intervention in 29%. Increasing awareness among ATV and dirt bike riders about the severity of riding-related injuries may encourage safer riding behaviors.

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Characterization of all-terrain vehicle-related thoracolumbar spine injury patterns in children using the AOSpine classification system

Cited by 3 publications

References 28 publications

Traumatic Spinal Injury Associated with All-Terrain Vehicle (ATV) Accidents: A 10-Year Retrospective Analysis of the Coachella Valley

Traumatic Spinal Injury Associated with All-Terrain Vehicle (ATV) Accidents: A 10-Year Retrospective Analysis of the Coachella Valley

Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients

Pediatric spinal injury patterns and management in all-terrain vehicle and dirt bike crashes, 2010–2019

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