Bicycle-related cervical spine injuries

Area of Science:

• Trauma surgery
• Orthopedics
• Epidemiology

Background:

• Bicyclists are recognized as vulnerable road users.
• Cervical spine injuries (CSIs) represent a significant concern in traffic safety.
• Understanding injury patterns in bicycle-related trauma is crucial for prevention and treatment.

Purpose of the Study:

• To characterize all bicycle-related traumatic cervical spine injuries (CSIs) in Norway's South-East region from 2015-2019.
• To determine if specific types of CSIs are more prevalent in bicyclists compared to other trauma mechanisms.
• To identify risk factors associated with certain CSI types in bicycle incidents.

Main Methods:

• A retrospective cohort study utilizing prospectively collected registry data.
• Analysis of all CSIs in the South-East region of Norway (3.0 million inhabitants) between 2015 and 2019.
• Descriptive statistics for patient characteristics, injury types, and treatments; Bayesian multivariable logistic regression for risk factor analysis.

Main Results:

• 261 (12%) of 2,162 CSIs were bicycle-related, with an incidence of 1.7/100,000 person-years.
• Common bicycle-related CSIs included C6/C7 fracture (28%), occipital condyle fracture (OC-Fx) (23%), and C5/C6 fracture (19%).
• Bicyclists had a significantly increased risk of OC-Fx (OR=2.8) and were more likely to sustain multiple traumas compared to non-bicyclists.

Conclusions:

• Bicycle crashes are a notable cause of CSIs in the Norwegian population.
• C6/C7 fractures, occipital condyle fractures, and C5/C6 fractures are the most frequent CSIs among bicyclists.
• Public health awareness and targeted safety measures for cyclists are warranted.