Spinal Injuries in an Airplane Crash A Description of Incidence, Morphology, and Injury Mechanism

Study Design. Retrospective cohort. Objective. Spinal injuries of the survivors of an airplane crash are described. On the basis of injury morphology and knowledge of the conditions of the accident, injury mechanisms are described and prevention measures are discussed. Summary of Background Data. The most common causes of spinal fractures are a high energy fall (incidence 21.2%-39%) and motor vehicle accidents (21.7%-33.61%). Detailed reports solely on spinal injuries, as a result of an airplane crash, are scarce in literature. Methods. An analysis was performed on the spinal injuries of all 126 survivors of a commercial airplane (Boeing 737) crash near Amsterdam in 2009. Level of injury and fracture classification by morphology, independently performed by 4 specialists in spinal trauma, was documented. An analysis was done on the type of injuries and the suggested mechanism of injury by evaluating the crash characteristics analysis. Results. Twenty-three (18.3%) of the survivors sustained a total of 27 spinal injuries. Four (17.1% of the patients with spinal injury) experienced a single cervical spine fracture. Eight (29.6%) injuries were at the thoracic spine and 15 (55.6%) at the lumbar spine level. More than half of the injuries included a burst component. Conclusion. A high number of spinal injuries was found after this airplane crash. The morphology of the injuries consisted of a high rate of burst-type fractures presumably caused by a mainly vertical trauma mechanism as shown by the accident analysis.