Citation

Donnally CJ, Metser G, Roth ES, Young JPM, Rush AJ, Al Maaieh MA. Spine 2018; 43(17): E1033-E1039.

Affiliation

University of Miami Hospital, Department of Orthopedics, Miami, FL.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0000000000002594

PMID

29419715

Abstract

STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To identify patient characteristics and associated injuries in those sustaining a spine fracture from personal watercraft (PWC) usage. SUMMARY OF BACKGROUND DATA: There are few studies regarding PWC use and injuries, and even more scarce are studies evaluating PWC usage and spine injuries. Identifying high risk actions and individuals can help to effectively treat them, reduce mortality, and possibly avoid certain spine fractures.

METHODS: Retrospective analysis of 142 patients admitted from the emergency department with PWC related injuries at a single level I trauma center from January 1, 2004 to May 1st, 2017. 26 (18.3%) sustained a spine fracture, totaling 71 fractures. Statistical analysis was used to investigate the patient characteristics, specific mechanisms of injury (MOI), injury severity score (ISS), and associated injuries. Patients expiring (12) had incomplete evaluations and were excluded from most reported results.

RESULTS: Spine fractures were not associated with age, race or gender, but were associated with a higher ISS, ICU length, in-patient length of stay (LOS), cerebral injury, and abdominal/genitourinary (GU) injury. There were 8 cervical fractures, 22 thoracic fractures, 33 lumbar, and 8 sacral fractures. Axial load injuries were associated with vertebral body fractures and specifically burst fractures. Being a driver or passenger did not influence likelihood of a spine fracture, but did correlate with abdominal/GU injury. 5 (19.2%) of patients with spine fractures required 8 spine surgeries during admission. Mortality was associated with females, severe systemic injuries (ISS ≥ 15), direct collision MOI and the spring season.

CONCLUSION: PWC usage may result in spine fractures with a moderate percentage requiring orthopedic surgery. Additional studies should examine how hull or seat modifications can lessen the risk of axial loads leading to spine fractures. PWC patients with spine fractures should also be evaluated for abdominal/GU and cerebral injuries at presentation. LEVEL OF EVIDENCE: 4.

Language: en