Fatal cervical spinal injuries in road traffic accidents

Abstract

The present study analyses fatal road traffic accidents involving private cars and vans in Finland during the period 1972–1982, in which an injury to the cervical spine was the main cause of death. The material consists of 289 victims; this being 10.5 per cent of all the fatalities in this category of road traffic accidents. Front seat and rear seat passengers seem to have an equal risk of sustaining a fatal cervical spinal injury. However, front seat passengers have a significantly greater chance ( P < 0.001) of having fatal cervical spinal injuries than the drivers. Of the victims 21.1 per cent had worn safety belts but there was no statistical difference between those who did and those who did not wear safety belts. Increasing age seems to increase the risk of fatal cervical spinal injuries. Patients between 16 and 25 years of age had the lowest risk and patients over the age of 60 had the highest risk of sustaining a fatal cervical spinal injury ( P < 0.001). In 48.1 per cent of the cases, the victims were multiply injured and this is similar to other main causes of death in road traffic accidents. Wearers of safety belts had significantly ( P < 0.001) more multiple injuries. Of the patients who died of cervical injury, only 8.8 per cent survived transportation to hospital and 1.4 per cent survived longer than 24 hours. A direct blow was the most common mechanism of the cervical injury (47.1 per cent) and deceleration was found in 13.1 per cent of the cases. Deceleration was more common in victims wearing safety belts ( P < 0.001). The wearing of safety belts could well have saved 39.1 per cent of the fatally injured victims. Furthermore, head and neck supports could have saved 14.3 per cent of the victims whose cervical spinal injury was caused by deceleration.