Citation

Rao RD, Sobel EH, Berry CA, Yoganandan N. Spine 2015; 41(1): 32-38.

Affiliation

#Department of Orthopaedic Surgery, George Washington University *Department of Orthopaedic Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA ^Department of Orthopaedic Surgery, Boston Medical Center, 1 Boston Medical Center Place, Boston, MA 02115, USA **Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0000000000001079

PMID

26230541

Abstract

STUDY DESIGN: Retrospective study of a prospectively gathered database.

OBJECTIVE: To investigate the incidence and pattern of T and L spine injuries among elderly subjects involved in MVC. SUMMARY OF BACKGROUND DATA: Adults age 65 and older currently constitute more than 16% of all licensed drivers. Despite driving less than the young, older drivers are involved in a higher proportion of crashes. Notwithstanding the safety features in modern vehicles, 15.8-51% of all thoracic and lumbar (T and L) spine injuries result from motor vehicle collisions (MVC).

METHODS: CIREN database is a prospectively maintained, multi-centered database that enrolls MVC occupants with moderate to severe injuries. It was queried for T and L spine injuries in subjects 65 and older. One hundred and forty-two CIREN files for all elderly individuals were reviewed for demographic, injury and crash data. Each occupant's T and L injury was categorized using a modified Denis classification.

RESULTS: Of 661 elderly subjects, 142 (21.48%) sustained T and L spine injuries. Of the 102 major injuries there were 63 compression, 20 burst and 12 extension fractures. Seatbelt use predisposed elderly subjects to compression and burst fractures while seatbelt and airbag use predisposed to burst fractures. Deployment of airbags without seatbelt use appeared to predispose elderly subjects to neurologic injury, higher ISS and higher mortality. Occupants using three-point belts who had airbags deploy during the collision had the lowest rates of fatality and neurologic injury.

CONCLUSIONS: T and L spine injuries in the elderly are not uncommon despite restraint use. While seatbelts used alone and in conjunction with airbag deployment reduced fatalities and neurologic injuries in the elderly, deployment of airbags in occupants without seatbelts predisposed to more severe injury.

Language: en