Comparison of Traumatic Spinal Fracture Patterns Between Motorcyclists and Occupants of Other Non-heavy Motor Vehicles: A Report from the National Spinal Cord and Column Injury Registry of Iran (NSCIR-IR)

Objectives To compare traumatic spinal injury patterns between motorcyclists and occupants of other non-heavy motor vehicles using data from the National Spinal Cord and Column Injury Registry of Iran (NSCIR-IR). Methods All drivers/riders and passengers of motorcycles, cars, pick-up trucks, and vans registered between January 2017 to July 2023, met the inclusion criteria for the present study. The logistic regression models were used to compare the patterns of vertebral fracture between the two groups. Results 1726 spinal fracture patients were identified, 385 (22.3%) motorcyclists and 1341 (77.7%) car occupants with mean ages 33.2±14.3 and 36.1±13.6 years, respectively (P<0.001). Only 45 (11.7%) motorcyclists used helmets, whereas 856 (63.8%) car occupants used seat belts (P<0.001). The average numbers of fractured vertebrae were 3.9±1.4 and 3.7±1.1 among car occupants and motorcyclists, respectively (P=0.004). The proportions of motorcyclists and car occupants with injuries in each spinal region are as follows: lumbar (50.5% of motorcyclists vs. 40.4% of car occupants; P=0.003), thoracic (39.2% vs. 30.9%; P=0.01), cervical (24.3% vs. 37.0%; P<0.001) and sacral (1.3% vs. 7.5%; P<0.001). The AO Spine type C injuries were present in 6.1% of motorcyclists and 10.1% of car occupants (P=0.03). Conclusion Motorcyclists were younger, less educated, had a higher proportion of males, and less commonly used safety devices than car occupants. The most commonly fractured spine region among both groups was the lumbar region. The cervical and sacral vertebrae fractures were significantly more common in car occupants, whereas the thoracic and lumbar vertebrae fractures were significantly more common in motorcyclists.