Authors: Aaron Michael Yengo-Kahn, MD
Pediatric spinal injuries in all-terrain vehicle (ATV) and dirtbike crashes are relatively uncommon but may be associated with significant morbidity. There are no recent studies examining these injuries, their management and outcomes. We performed a retrospective study to characterize pediatric spinal injuries related to ATV and dirt-bike crashes over the last decade.Methods: Data on patients involved in ATV or dirtbike crashes treated at a regional level 1 pediatric trauma center between 2010-2019, were analyzed. Descriptive statistics, Chi-squared, Fisher exact and Mann-Whitney U tests were performed comparing the demographics, injury characteristics, and clinical outcomes patients with SPINE injuries to those without.
Of 680 patients were included, only 35 (5.1%) were diagnosed with SPINE injuries. 100% of SPINE injuries were diagnosed on CT scans and 62.9% underwent a SPINE MRI. Injuries were most commonly thoracic (48.6%), followed by cervical (37.1%). Most patients were ASIA E on presentation, 2 (5.7%) had complete spinal cord injuries (ASIA A) and 3 (8.6%) patients were ASIA B-D. Operative management was required for 25.7% of spinal injuries with most (77.8%) requiring decompression and internal fixation. Non-operative management consisted of bracing in 53.8%. Patients with SPINE injuries were older (13.2±3.35 vs 11.4±3.84, p=0.007). SPINE injuries occurred via similar crash mechanisms as non-SPINE injuries (p=0.12). Patients with SPINE injuries more frequently required admission to the intensive care unit (ICU, 37.1% vs 15.2%, p=0.002) and had longer hospital stays (4.9±5.7 vs 2.7±4.0 days, p=0.004).
Although infrequent among young ATV and dirtbike riders, spinal injuries are associated with longer hospital stays, increased ICU utilization and operative intervention in about 25%. Increasing awareness among ATV and dirtbike riders about the severity of riding-related injuries may encourage safer riding behaviors.