Incidence and mechanism of neurological deficit after thoracolumbar XXXX sustained in motor vehicle collisions.

@entity3675 @entity28 @entity174 @entity16 @entity1566 @entity130
UNASSIGNED: OBJECT To determine the incidence of and assess the risk factors associated with @entity16 in motor vehicle occupants who sustain @entity174 of the thoracolumbar spine. METHODS In this study, the authors queried medical, vehicle, and crash data elements from the Crash Injury Research and Engineering Network (CIREN), a prospectively gathered multicenter database compiled from Level I @entity130 centers. Subjects had @entity174 involving the T1-L5 vertebral segments, an @entity130 ( @entity130 ) score of >=  3, or @entity130 with an @entity130 score of >=  2 in each region. Demographic parameters obtained for all subjects included age, sex, height, body weight, and body mass index. Clinical parameters obtained included the level of the injured vertebra and the level and type of @entity1566 . Vehicular crash data included vehicle make, seatbelt type, and usage and appropriate use of the seatbelt. Crash data parameters included the principal direction of force, change in velocity on impact (  V), airbag deployment, and vehicle rollover. The authors performed a univariate analysis of the incidence and the odds of sustaining spinal @entity16 associated with @entity174 with respect to the demographic, clinical, and crash parameters. RESULTS Neurological deficit associated with thoracolumbar @entity174 was most frequent at extremes of age; the highest rates were in the 0- to 10-year (26.7% [4 of 15]) and 70- to 80-year (18.4% [7 of 38]) age groups. Underweight occupants (OR 3.52 [CI 1.055-11.7]) and @entity28 occupants (OR 3.27 [CI 1.28-8.31]) both had higher odds of sustaining @entity1566 than occupants with a normal body mass index. The highest risk of @entity16 existed in crashes in which airbags deployed and the occupant was not restrained by a seatbelt (OR 2.35 [CI 0.087-1.62]). Reduction in the risk of @entity16 occurred when 3-point seatbelts were used correctly in conjunction with the deployment of airbags (OR 0.34 [CI 1.3-6.6]) compared with the occupants who were not restrained by a seatbelt and for whom airbags were not deployed. Crashes with a   V greater than 50 km/hour had a significantly higher risk of @entity1566 (OR 3.45 [CI 0.136-0.617]) than those at lower   V values. CONCLUSIONS Deployment of airbags was protective against @entity16 only when used in conjunction with 3-point seatbelts. @entity3675 who were either @entity28 or underweight, very young or elderly, and those in crashes with a   V greater than 50 km/hour were at higher risk of thoracolumbar @entity16 . @entity16 at thoracic and lumbar levels was associated with multiple factors, including the incidence of fatality, occupant factors such as age and body habitus, energy at impact, and direction of impact. Current vehicle safety technologies are geared toward a normative body morphology and need to be reevaluated for various body morphologies and torso compliances to lower the risk of @entity16 resulting from thoracolumbar @entity174 .
