An article and accompanying editorial published in the February 2009 issue of Journal of Neurosurgery: Spine provide compelling evidence that the combination of air bags and seat belts offers the best protection against spine fractures sustained in motor vehicle crashes, according to a recent press release. This research examined the records of more than 20,000 crash victims age 16 and older admitted to Wisconsin hospitals after car or truck crashes from 1994 to 2002.

Article authors are: Marjorie C. Wang, MD, MPH, Frank Pintar, PhD, Narayan Yoganandan, PhD, and Dennis J. Maiman, MD, PhD, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee. The editorial was written by Charles H. Tator, MD, PHD, Division of Neurosurgery, Toronto Western Hospital and University of Toronto.

Dr. Wang and her team analyzed the data and correlated the incidence of spine fractures with air bag and seat belt usage. Of the 29,860 motor vehicle crash hospital admissions, a data group of 20,276 drivers and front seat passengers was analyzed. This group met the following criteria: drivers or front seat passengers age 16 or older with complete ICD-9-CM and air bag/seat belt data who were not ejected from the vehicle. Key research findings include:

• Use of a seat belt and an air bag together was associated with a decreased risk of a spine fracture, including more severe fractures.
• Only 14 percent of the drivers and front seat occupants involved in Wisconsin motor vehicle crashes between 1994 and 2002 were protected by the combination of air bags and seat belts, although this number increased from 1994 to 2002.
• 38 percent of these crash victims were not wearing seat belts.
• There were 2,530 spine fractures (12.5 percent) identified among the 20,276 hospital admissions: 1,067 cervical fractures, 565 thoracic fractures, and 1,034 lumbosacral fractures. Eighty-two patients (8 percent) with a cervical fracture also had a thoracic and/or a lumbosacral fracture. Fifty-four patients with a thoracic fracture, (10 percent) also had a lumbosacral fracture. Eight percent of these were classified as severe.
• Use of an air bag alone was associated with an increased risk of a severe thoracic spine fracture.

Access the article, “The continued burden of spine fractures after motor vehicle crashes,” online at http://thejns.org/doi/full/10.3171/SPI.2008.10.08279, and the editorial at http://thejns.org/doi/full/10.3171/SPI.2008.10.08706.