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Spinal injuries in airborne accidents: a demographic overview of 148 patients in a level-1 trauma center

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Abstract

Purpose

The purpose of this study was to investigate the type and severity of spinal injury in airborne sports, as well as patients demographics in this unique set of athletes. Paragliding is one of the most popular airborne sports in Switzerland, which thought to be no less dangerous with a high potential for spinal injury. Few studies on spinal column injuries have been performed in these high-risk athletes with only inconsistent findings.

Methods

Patient charts were analyzed for all airborne sports injuries affecting the spine from 2010 to 2017 at a level-1 trauma center in Switzerland. To classify the injuries, we used the newest AOSpine classification, ASIA-grading and the injury severity score (ISS). In total, 235 patients were admitted to the emergency department due to an airborne injury. A total of 148 patients (148/235, 63.0%) which were predominantly male (125/235, 84.5%) at a mean age of 39.4 years suffered 334 spinal fractures and 5 spinal contusions. The mean ISS was 17.3, and the L1 vertebra was most commonly affected (47.6% of cases, 68/148).

Results

A total of 78 patients (54.5% or 78/148) required spine surgery due to instability or neurological deficits (31/148 patients; 20.9%). Concomitant injuries were identified in 64.2% of cases (n = 95).

Conclusion

Due to the increasing popularity of airborne sports, age of patients and severity of injuries (ISS) increased compared with the literature. The thoracolumbal spine is at especially high risk. To prevent further complications, the treatment procedure has to be sought carefully and algorithm should be introduced in clinics to avoid delay in diagnostics and surgery.

Level of evidence

III, retrospective comparative study.

Graphical abstract

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References

  1. Leucht P, Fischer K, Muhr G, Mueller EJ (2009) Epidemiology of traumatic spine fractures. Injury 40:166–172. https://doi.org/10.1016/j.injury.2008.06.040

    Article  PubMed  Google Scholar 

  2. Wang H, Xiang Q, Li C, Zhou Y (2013) Epidemiology of traumatic cervical spinal fractures and risk factors for traumatic cervical spinal cord injury in China. J Spinal Disord Tech 26:E306–E313. https://doi.org/10.1097/BSD.0b013e3182886db9

    Article  PubMed  Google Scholar 

  3. Wang H, Zhang Y, Xiang Q, Wang X, Li C, Xiong H, Zhou Y (2012) Epidemiology of traumatic spinal fractures: experience from medical university-affiliated hospitals in Chongqing, China, 2001–2010. J Neurosurg Spine 17:459–468. https://doi.org/10.3171/2012.8.SPINE111003

    Article  PubMed  Google Scholar 

  4. Boden BP, Breit I, Beachler JA, Williams A, Mueller FO (2013) Fatalities in high school and college football players. Am J Sports Med 41:1108–1116. https://doi.org/10.1177/0363546513478572

    Article  PubMed  Google Scholar 

  5. Corra S, Girardi P, de Giorgi F, Braggion M (2012) Severe and polytraumatic injuries among recreational skiers and snowboarders: incidence, demographics and injury patterns in South Tyrol. Eur J Emerg Med 19:69–72. https://doi.org/10.1097/MEJ.0b013e328347c1e9

    Article  PubMed  Google Scholar 

  6. Gosteli G, Yersin B, Mabire C, Pasquier M, Albrecht R, Carron PN (2016) Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports. Injury 47:1414–1420. https://doi.org/10.1016/j.injury.2016.03.025

    Article  PubMed  Google Scholar 

  7. Silva L, Fernanda Bellolio M, Smith EM, Daniels DJ, Lohse CM, Campbell RL (2017) Motocross-associated head and spine injuries in adult patients evaluated in an emergency department. Am J Emerg Med 35:1485–1489. https://doi.org/10.1016/j.ajem.2017.04.058

    Article  PubMed  Google Scholar 

  8. Schulze W, Richter J, Schulze B, Esenwein SA, Buttner-Janz K (2002) Injury prophylaxis in paragliding. Br J Sports Med 36:365–369

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Cevik AA, Kaya FB, Acar N, Sahin A, Ozakin E (2017) Injury, hospitalization, and operation rates are low in aerial sports. Turk J Emerg Med 17:81–84. https://doi.org/10.1016/j.tjem.2016.11.004

    Article  PubMed  Google Scholar 

  10. Feletti F, Goin J (2014) Accidents and injuries related to powered paragliding: a cross-sectional study. BMJ Open 4:e005508. https://doi.org/10.1136/bmjopen-2014-005508

    Article  PubMed  PubMed Central  Google Scholar 

  11. Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, Reinhold M, Aarabi B, Kandziora F, Chapman J, Shanmuganathan R, Fehlings M, Vialle L, Injury AOSC, Trauma Knowledge F (2013) AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine (Phila Pa 1976) 38:2028–2037. https://doi.org/10.1097/brs.0b013e3182a8a381

    Article  Google Scholar 

  12. Vaccaro AR, Koerner JD, Radcliff KE, Oner FC, Reinhold M, Schnake KJ, Kandziora F, Fehlings MG, Dvorak MF, Aarabi B, Rajasekaran S, Schroeder GD, Kepler CK, Vialle LR (2016) AOSpine subaxial cervical spine injury classification system. Eur Spine J 25:2173–2184. https://doi.org/10.1007/s00586-015-3831-3

    Article  PubMed  Google Scholar 

  13. Kepler CK, Vaccaro AR, Koerner JD, Dvorak MF, Kandziora F, Rajasekaran S, Aarabi B, Vialle LR, Fehlings MG, Schroeder GD, Reinhold M, Schnake KJ, Bellabarba C, Cumhur Oner F (2016) Reliability analysis of the AOSpine thoracolumbar spine injury classification system by a worldwide group of naive spinal surgeons. Eur Spine J 25:1082–1086. https://doi.org/10.1007/s00586-015-3765-9

    Article  PubMed  Google Scholar 

  14. Ebrahimi M, Pirazghandi H, Reihani HR (2015) How is the injury severity scored? a brief review of scoring systems. Clin Med 2:125–128. https://doi.org/10.17463/RCM.2015.03.004

    Article  Google Scholar 

  15. Chen Y, Tang Y, Vogel LC, Devivo MJ (2013) Causes of spinal cord injury. Top Spinal Cord Inj Rehabil 19:1–8. https://doi.org/10.1310/sci1901-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Tomlinson J, Athanassacopoulos M (2015) Adult vertebral fractures. Surgery 33:264–276. https://doi.org/10.1016/j.mpsur.2015.03.005

    Article  Google Scholar 

  17. Hasler RM, Huttner HE, Keel MJ, Durrer B, Zimmermann H, Exadaktylos AK, Benneker LM (2012) Spinal and pelvic injuries in airborne sports: a retrospective analysis from a major Swiss trauma centre. Injury 43:440–445. https://doi.org/10.1016/j.injury.2011.06.193

    Article  PubMed  Google Scholar 

  18. Gauler R, Moulin P, Koch HG, Wick L, Sauter B, Michel D, Knecht H (2006) Paragliding accidents with spinal cord injury: 10 years’ experience at a single institution. Spine (Phila Pa 1976) 31:1125–1130. https://doi.org/10.1097/01.brs.0000216502.39386.70

    Article  Google Scholar 

  19. Canbek U, Imerci A, Akgun U, Yesil M, Aydin A, Balci Y (2015) Characteristics of injuries caused by paragliding accidents: a cross-sectional study. World J Emerg Med 6:221–224. https://doi.org/10.5847/wjem.j.1920-8642.2015.03.011

    Article  PubMed  PubMed Central  Google Scholar 

  20. Dekker R, Kingma J, Groothoff JW, Eisma WH, Ten Duis HJ (2000) Measurement of severity of sports injuries: an epidemiological study. Clin Rehabil 14:651–656. https://doi.org/10.1191/0269215500cr374oa

    Article  CAS  PubMed  Google Scholar 

  21. Lack DA, Sheets AL, Entin JM, Christenson DC (2012) Rock climbing rescues: causes, injuries, and trends in Boulder County, Colorado. Wilderness Environ Med 23:223–230. https://doi.org/10.1016/j.wem.2012.04.002

    Article  PubMed  Google Scholar 

  22. Weber CD, Horst K, Nguyen AR, Lefering R, Pape HC, Hildebrand F, TraumaRegister DGU (2018) Evaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis. Arch Orthop Trauma Surg 138:963–970. https://doi.org/10.1007/s00402-018-2935-8

    Article  PubMed  Google Scholar 

  23. Hohlrieder M, Lutz M, Schubert H, Eschertzhuber S, Mair P (2007) Pattern of injury after rock-climbing falls is not determined by harness type. Wilderness Environ Med 18:30–35

    Article  PubMed  Google Scholar 

  24. Palmer C (2007) Major trauma and the injury severity score–where should we set the bar? Annu Proc Assoc Adv Automot Med 51:13–29

    PubMed  PubMed Central  Google Scholar 

  25. Fasching G, Schippinger G, Pretscher R (1997) Paragliding accidents in remote areas. Wilderness Environ Med 8:129–133

    Article  CAS  PubMed  Google Scholar 

  26. Rekand T (2012) The epidemiology of injury in hang-gliding and paragliding. Med Sport Sci 58:44–56. https://doi.org/10.1159/000338581

    Article  PubMed  Google Scholar 

  27. Zeller T, Billing A, Lob G (1992) Injuries in paragliding. Int Orthop 16:255–259

    Article  CAS  PubMed  Google Scholar 

  28. Bakhsheshian J, Dahdaleh NS, Fakurnejad S, Scheer JK, Smith ZA (2014) Evidence-based management of traumatic thoracolumbar burst fractures: a systematic review of nonoperative management. Neurosurg Focus 37:E1. https://doi.org/10.3171/2014.4.FOCUS14159

    Article  PubMed  Google Scholar 

  29. McGoldrick NP, Green C, Burke N, Synnott K (2012) Acute traumatic spinal injury following bicycle accidents: a report of three cases. Acta Orthop Belg 78:409–413

    PubMed  Google Scholar 

  30. Smits AJ, Polack M, Deunk J, Bloemers FW (2017) Combined anteroposterior fixation using a titanium cage versus solely posterior fixation for traumatic thoracolumbar fractures: a systematic review and meta-analysis. J Craniovertebr Junction Spine 8:168–178. https://doi.org/10.4103/jcvjs.JCVJS_8_17

    Article  PubMed  PubMed Central  Google Scholar 

  31. Reinhold M, Knop C, Beisse R, Audige L, Kandziora F, Pizanis A, Pranzl R, Gercek E, Schultheiss M, Weckbach A, Buhren V, Blauth M (2009) Operative treatment of traumatic fractures of the thoracic and lumbar spinal column: part III: follow up data. Unfallchirurg 112:294–316. https://doi.org/10.1007/s00113-008-1539-0

    Article  CAS  PubMed  Google Scholar 

  32. Soreide K, Ellingsen CL, Knutson V (2007) How dangerous is BASE jumping? An analysis of adverse events in 20,850 jumps from the Kjerag Massif, Norway. J Trauma 62:1113–1117. https://doi.org/10.1097/01.ta.0000239815.73858.88

    Article  PubMed  Google Scholar 

  33. Feletti F (2017) Extreme sports medicine. Springer, Cham

    Book  Google Scholar 

  34. Reinhold M, Audige L, Schnake KJ, Bellabarba C, Dai LY, Oner FC (2013) AO spine injury classification system: a revision proposal for the thoracic and lumbar spine. Eur Spine J 22:2184–2201. https://doi.org/10.1007/s00586-013-2738-0

    Article  PubMed  PubMed Central  Google Scholar 

  35. Stevenson M, Segui-Gomez M, Lescohier I, Di Scala C, McDonald-Smith G (2001) An overview of the injury severity score and the new injury severity score. Inj Prev 7:10–13

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, University Hospital of Bern (Inselspital), Bern, Switzerland

    Henrik C. Bäcker, Lorin Benneker, Fabian Krause, Sven Hoppe & Moritz C. Deml

  2. Department of Orthopaedic Surgery, Columbia University Medical Center/Presbyterian Hospital, New York, USA

    Henrik C. Bäcker & J. Turner Vosseller

  3. Department of Orthopaedic Surgery and Traumatology, Cantonal Hospital of Lucerne, Berne, Switzerland

    Markus Noger

Authors
  1. Henrik C. Bäcker
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  2. J. Turner Vosseller
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Correspondence to Henrik C. Bäcker.

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Conflict of interest

Henrik C. Bäcker, J. Turner Vosseller, Lorin Benneker, Markus Noger, Fabian Krause, Sven Hoppe and Moritz C. Deml have no conflict of interest directly related to this work.

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IRB: IRB Approval was obtained from the Swiss ethical committee.

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Cite this article

Bäcker, H.C., Vosseller, J.T., Benneker, L. et al. Spinal injuries in airborne accidents: a demographic overview of 148 patients in a level-1 trauma center. Eur Spine J 28, 1138–1145 (2019). https://doi.org/10.1007/s00586-019-05951-0

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  • DOI: https://doi.org/10.1007/s00586-019-05951-0

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