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Spinal Injuries in Motorcycle Crashes: Patterns and Outcomes

Robertson, Angus BSc, MRCS(Ed); Giannoudis, Peter V. MD, EEC(Orth); Branfoot, Toby FRCSEd(Tr & Orth), MSc; Barlow, Ian; Matthews, Stuart J. FRCS; Smith, Raymond M. MD, FRCS

The Journal of Trauma: Injury, Infection, and Critical Care: July 2002 - Volume 53 - Issue 1 - p 5-8
Original Articles

Background  The purpose of this study was to determine patterns of spinal injury and clinical outcomes resulting from motorcycle crashes.

Methods  We analyzed data collected on 1,121 motorcyclists involved in road traffic accidents (from 1993–2000) and identified those who had sustained a spinal injury.

Results  Spinal injury occurred in 126 (11.2%) riders (112 male riders [88.9%] and 14 female riders [11.1%]), with a mean age of 30.2 years (range, 16–61 years) and Injury Severity Score of 18.8 (range, 4–66). Isolated injuries to the spine occurred in 30 (23.8%) riders. The thoracic spine was injured in 69 (54.8%), the lumbar spine in 37 (29.4%), and the cervical spine in 34 (27.0%) cases. Multiple vertebral levels were affected in 54 (42.9%). Neurologic injury occurred in 25 riders (19.8%), with complete distal neurologic injury in 14 (4 cervical, 9 thoracic, and 1 lumbar). Eleven (8.7%) patients required spinal surgery. There were 13 (10.3%) deaths.

Conclusion  The thoracic spine is the most commonly injured spinal region in motorcycle crashes. Multiple level injuries are common. Protocols concentrating on the radiographic clearance of the cervical region may miss a significant number of spinal injuries. Vigilance is required in assessing these patients, who often have multiple injuries.

From the Department of Trauma and Orthopaedic Surgery, St. James’s University Hospital, Beckett Street, Leeds, United Kingdom.

Submitted for publication July 5, 2001.

Accepted for publication February 19, 2002.

Address for reprints: P. V. Giannoudis, MD, EEC(Orth), Department of Trauma and Orthopaedic Surgery, St. James’s University Hospital, Beckett Street, Leeds LS9 7TF, West Yorkshire, United Kingdom; email:

© 2002 Lippincott Williams & Wilkins, Inc.