Airbag-induced fatal subaxial cervical spinal cord injury in a low-velocity collision

The effectiveness of airbags as a modern restraining system for car occupants in frontal collisions has been well demonstrated in experimental studies and real accidents; however, they can themselves be responsible for injuries, fatal in some circumstances. We hereby report a lethal cervical spinal cord injury in a patient with ankylosed cervical spine, caused by a hyperextension injury after a motor vehicle collision, in which the airbag had been deployed in the absence of shoulder or lap belt harnesses. This led to fatal injuries resulting from the inflating airbag striking against the face and chin of the victim. Postmortem examination showed a complete transection of the cord in association with the transverse fracture through the body of C5 and the involvement of all three spinal columns. The focus of this report is to emphasize the importance of the proper use of such restraining systems. The potential for cervical spine hyperextension injuries in unrestrained passengers in atypical positions in front of airbags, particularly those with a rigid segment of ankylosed cervical spine and other predisposing factors, are discussed.