Mechanisms and risk factors associated with spinal cord injury, facet fracture, and level of dislocation, in occupants with cervical spine dislocations sustained in motor vehicle crashes

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dc.contributor.authorForoutan, P.
dc.contributor.authorQuarrington, R.D.
dc.contributor.authorJones, C.F.
dc.date.issued2024
dc.descriptionPublished online: 13 Aug 2024
dc.description.abstractOBJECTIVE: Motor vehicle crashes (MVCs) are the leading cause of cervical spine dislocation. The mechanisms underlying this injury are unclear, limiting the development of injury prevention devices and strategies. MVC databases contain occupant, medical, vehicle, and crash details that are not routinely collected elsewhere, providing a unique resource for investigating injury mechanisms and risk factors. In this study, a comprehensive standalone analysis of cervical spine dislocations captured in MVC databases was performed. METHODS: Epidemiologic, biomechanical, and injury data were extracted from three MVC databases. Logistic regression models were developed to determine the occupant, vehicle, and crash characteristics, as well as the global (inertial or impact) and regional (flexion, compression, etc.) loading mechanisms associated with the level of cervical spine dislocation (axial or sub-axial), and the occurrence of spinal cord injury (SCI) or facet fracture concomitant to dislocation. RESULTS: There was no association between global or regional injury mechanisms and the level of cervical spine dislocation. Sub-axial dislocations were typically due to head/face impact with the airbag or upper interior components, or a result of seatbelt restraint of the torso. Higher occupant age, lower BMI, partial/no ejection, and frontal and side configuration crashes (compared to rollovers) were associated with a higher likelihood of sub-axial, versus axial, dislocation. Amongst all dislocations, an increased likelihood of SCI was associated with impact injuries, airbag non-deployment, and complete ejection, while concomitant facet fracture was associated with the presence of regional compression. Severe crashes, partial ejections, and "utility vehicles" and "vans and trucks" (compared with "passenger vehicles") were associated with a higher risk of facet fracture concomitant to sub-axial dislocation. CONCLUSION: The findings of this study may be used to inform the loading modes to be simulated in future ex vivo or computational models seeking a better understanding of cervical spine dislocations.
dc.description.statementofresponsibilityParham Foroutan, Ryan D. Quarrington and Claire F. Jones
dc.identifier.citationTraffic Injury Prevention, 2024; 25(8):1129-1136
dc.identifier.doi10.1080/15389588.2024.2378133
dc.identifier.issn1538-9588
dc.identifier.issn1538-957X
dc.identifier.orcidForoutan, P. [0000-0002-0510-8518]
dc.identifier.orcidQuarrington, R.D. [0000-0002-0633-2482]
dc.identifier.orcidJones, C.F. [0000-0002-0995-1182]
dc.identifier.urihttps://hdl.handle.net/2440/143518
dc.language.isoen
dc.publisherTaylor and Francis Group
dc.relation.granthttp://purl.org/au-research/grants/arc/DP190101209
dc.rights© 2024 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
dc.source.urihttp://dx.doi.org/10.1080/15389588.2024.2378133
dc.subjectCervical facet dislocation
dc.subjectCIREN
dc.subjectfacet fracture
dc.subjectmotor vehicle crash
dc.subjectNASS-CDS
dc.subjectspinal cord injury
dc.subject.meshCervical Vertebrae
dc.subject.meshZygapophyseal Joint
dc.subject.meshHumans
dc.subject.meshSpinal Cord Injuries
dc.subject.meshSpinal Fractures
dc.subject.meshLogistic Models
dc.subject.meshRisk Factors
dc.subject.meshAccidents, Traffic
dc.subject.meshDatabases, Factual
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshMiddle Aged
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshYoung Adult
dc.subject.meshBiomechanical Phenomena
dc.subject.meshJoint Dislocations
dc.titleMechanisms and risk factors associated with spinal cord injury, facet fracture, and level of dislocation, in occupants with cervical spine dislocations sustained in motor vehicle crashes
dc.typeJournal article
pubs.publication-statusPublished

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