Epidemiology and Injury Biomechanics of Motor Vehicle Related Trauma to the Human Spine

Yoganandan, Narayan; Haffner, Mark P.; Maiman, Dennis J.; Nichols, Hunter; Pintar, Frank A.; Jentzen, Jeffrey M.; Weinshel, Steven S.; Larson, Sanford J.; Sances, Anthony

doi:10.4271/892438

Cited by 80 publications

(39 citation statements)

References 22 publications

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“…Chest injuries did not occur in isolation at AIS ≥3 levels. A similar conclusion was advanced in another study wherein an association was found between cranial and cervical column trauma (Yoganandan et al, 1990). In this previous study, cervical injuries were attributed to external load transfer from head impact within the interior component of the vehicle.…”

Section: Discussionsupporting

confidence: 80%

Lateral impact injuries with side airbag deployments—A descriptive study

Yoganandan

Pintar

Zhang

et al. 2007

Accident Analysis & Prevention

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The present study was designed to provide descriptive data on side impact injuries in vehicles equipped with side airbags using the United States National Automotive Sampling System (NASS). The database was queried with the constraint that all vehicles must adhere to the Federal Motor Vehicle Safety Standards FMVSS 214, injured occupants be in the front outboard seats with no rollovers or ejections, and side impacts airbags be deployed in lateral crashes. Out of the 7812 crashes in the 1997-2004 weighted NASS files, AIS ≥ 2 level injuries occurred to 5071 occupants. There were 3828 cases of torso-only airbags, 955 cases of torso-head bag combination, and 288 inflatable tubular structure/curtain systems. Side airbags were not attributed to be the cause of head or chest injury to any occupant at this level of severity. The predominance of torso-only airbags followed by torso-head airbag combination reflected vehicle model years and changing technology. Head and chest injuries were coupled for the vast majority of occupants with injuries to more than one body region. Comparing literature data for side impacts without side airbag deployments, the presence of a side airbag decreased AIS = 2 head, chest, and extremity injuries when examining raw data incidence rates. Although this is the first study to adopt strict inclusion-exclusion criteria for side crashes with side airbag deployments, future studies are needed to assess side airbag efficacy using datasets such as matched-pair occupants in side impacts.

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Section: Discussionsupporting

confidence: 80%

Lateral impact injuries with side airbag deployments—A descriptive study

Yoganandan

Pintar

Zhang

et al. 2007

Accident Analysis & Prevention

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“…Burke et al 14 in a hospital admission study, reported that C4-5 injuries accounted for 61% of all CSCI. Yoganandan et al 22 utilizing the National Accident Sampling System (NASS) reported that the most common levels of the injury in survivors were C5 and C6. Portnoy et al 21 also recorded a similar observation.…”

Section: Cervical Spinal Column Injurymentioning

confidence: 99%

Characteristics of injuries to the cervical spine and spinal cord in polytrauma patient population: experience from a regional trauma unit

et al. 1999

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Study design: Retrospective analysis of a prospectively collected trauma database of a Level 1 (tertiary) trauma center. Objective: To de®ne the features of the cervical spinal injuries in polytrauma population admitted to the regional trauma unit. Setting: Canada, Ontario Province, Toronto, Sunnybrook Health Sciences Center. Methods: All trauma admissions between 1987 and 1996 entered prospectively into a trauma registry database were studied for incidence, demographic and epidemiological details of cervical spine (cord and column) injuries. Results: A total of 468 patients (66% male) with cervical spinal injury (CSI) from 1198 spinal injuries admitted to the regional trauma center were identi®ed. Seventy-®ve per cent of the CSI involved were aged less than 50 years; nearly 30% were in the third decade alone. Overall, the commonest spinal level injured was C2 (27%) followed by C5 (22%). Older population (above 60 years of age) had C1+2 involved more often than the young (P=0.02). Motor vehicular crashes (MVC) accounted for 71%, followed by pedestrian trauma (10%), sport injuries (7%). Spinal cord injury (SCI) was noted in 27%; complete in 16% and incomplete in 11% and more frequently at C4 or C5 level compared with C1, C2 (P50.00001); the former level had more often a complete SCI (P=0.06). Though MVC produced 74% of SCI, only 27% had neurological de®cits. Recreational trauma produced SCI in 45%, motor cycle crashes (MCC) in 37% and a rear passenger in MVC in 34% that was complete in 78%, 71% and 73% respectively. Front seat passenger and driver in MVC had a C5 level injury while a rear seat passenger had at C4 (P50.001). The C1 level injury had high association with severe and life threatening head and neck and facial injuries compared with the more frequently injured spinal levels; either C2 (P=0.03) or C5 (P=0.004). Similarly C1 injuries had higher ISS compared with C2 (P50.0001) and C5 (P50.008). Conclusions: C2 was the commonest fractured spine while SCI was more frequent at C5. Older and pedestrian population had higher incidences of injuries at C1 and C2. Sport and MCC resulted in severe SCI. The level of spine injured was dierent between a front and a rear seat occupant in MVC.

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“…Cervical spine injury can occur during automobile collisions, and diving, football, and equestrian accidents [1][2][3]. Intact cervical spine ligaments provide passive stability to the spinal column, protecting the spinal cord from injury [4].…”

Section: Introductionmentioning

confidence: 99%