Seat Belts Protect Against Thoracolumbar Injury

There's no doubt that seatbelts save lives. They also reduce neck injuries. But do they protect the lower spine from trauma? That is the focus of this study comparing two groups of patients.

All patients in the study had a motor vehicle crash (MVC). They were riding in the front seat of a four-wheeled vehicle. The impact was from the front of the auto.

Injury occurred at the thoracolumbar junction (TLJ). This is the place in the spine where the thoracic vertebrae end (T12) and the lumbar vertebrae begin (L1). The first group of patients was restrained by a three-point seatbelt (lap-shoulder). The second group was not wearing a seatbelt when the accident occurred.

Two major types of injuries (fracture and dislocation) were compared between these two groups. The restrained group did not have any cases of dislocation. They had a 5.6 per cent incidence of neurologic deficits. This was compared with 33.3 per cent in the unrestrained group who had a neurologic problem as a result of fracture/dislocation.

The authors conclude that nonrestrained front seat occupants in MVCs have more severe TLJ injuries. This is likely the result of a more violent, traumatic force at the time of the impact. The unrestrained group was mostly male and much younger than the restrained group.

The results of this study support the idea that seatbelts protect the spine. However, it should be noted that restrained front-seat passengers still experience compression/burst fractures. The exact mechanism for this injury is unknown at this time.

Joji Inamasu, MD, PhD, and Bernard H. Guiot, MD, FRCSC. Thoracolumbar Junction Injuries After Motor Vehicle Collision: Are There Differences in Restrained and Nonrestrained Front Seat Occupants? In Journal of Neurosurgery: Spine. September 2007. Vol. 7. No. 3. Pp. 311-314.

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