Background: Spinal cord injury (SCI) is a potentially disabling neurologic injury that can occur in horseback riding. To date, no published study has examined the epidemiology of SCI from horseback riding in the United States, and few international studies exist on this topic. Several studies have described traumatic brain injuries, spine fractures, and extremity injuries; however, SCI patterns and outcomes in horseback riders are poorly understood.
Purpose: This study was undertaken to characterize the demographics, SCI patterns, and neurologic outcomes of persons with SCIs related to horseback riding.
Study Design: Descriptive epidemiologic study.
Methods: This is a retrospective review of 121 SCI cases from horseback riding in the National SCI Statistical Center database from 1973 to 2008. The treatment setting was 26 U.S. SCI Model Systems of Care. The number of injuries, gender, age, and SCI type for horseback riding were compared with other sports and activities. The level of preserved neurologic function, SCI completeness, American Spinal Injury Association classification, and mechanical ventilation use at discharge were examined in the horseback riding group.
Results: The mean age of injury was 37.8 years (standard deviation, 15.2). The majority of patients were white (88%) and female (50.4%). Compared with diving, motorcycle riding, football, and gymnastics, horseback riding involved a significantly higher number of women (P < .005), a higher mean age of injury, and an equal likelihood of resulting in paraplegia and tetraplegia. The most common levels of preserved neurologic function were C4-C6, T12, and L1. Spinal cord injury from horseback riding most commonly resulted in incomplete tetraplegia (41%) followed by complete paraplegia (24%). Only 4 patients required mechanical ventilation on discharge from acute inpatient rehabilitation.
Conclusion: Spinal cord injury from horseback riding affects an equal proportion of women and men, has a wide age range, and most commonly results in incomplete tetraplegia followed by complete paraplegia. Study findings improve awareness of the demographics and neurologic outcomes of individuals with SCI from horseback riding and can help guide future studies evaluating SCI mechanisms in horseback riders to improve injury prevention and management.
Background: Multiple studies have described in general the injuries associated with mountain biking, and detailed accounts of spine injuries sustained in hockey, gymnastics, skiing, snowboarding, rugby, and paragliding have previously been published. However, no large-scale detailed assessment of mountain biking associated spinal fractures and spinal cord injuries has previously been published.
Purpose: This study was undertaken to describe the patient demographics, injuries, mechanisms, treatments, outcomes, and resource requirements associated with spine injuries sustained while mountain biking.
Study Design: Case series; Level of evidence, 4.
Methods: Patients who were injured while mountain biking, and who were seen at a provincial spine referral center between 1995 and 2007 inclusive, with spinal cord injuries and/or spine fracture were included. A chart review was performed to obtain demographic data, and details of the injury, treatment, outcome, and resource requirements.
Results: A total of 102 men and 5 women were identified for inclusion. The mean age at injury was 32.7 years (95% confidence interval 30.6, 35.0). Seventy-nine patients (73.8%) sustained cervical injuries, while the remainder sustained thoracic or lumbar injuries. Forty-three patients (40.2%) sustained a spinal cord injury. Of those with cord injuries, 18 (41.9%) were American Spinal Injury Association (ASIA) A, 5 (11.6%) were ASIA B, 10 (23.3%) ASIA C, and 10 (23.3%) ASIA D. Sixty-seven patients (62.6%) required surgical treatment. The mean length of stay in an acute hospital bed was 16.9 days (95% confidence interval 13.1, 30.0). Thirty-three patients (30.8%) required intensive care unit attention, and 31 patients (29.0%) required inpatient rehabilitation. Of the 43 patients (40.2%) seen with spinal cord injuries, 14 (32.5%) improved by 1 ASIA category, and 1 (2.3%) improved by 2 ASIA categories. Two patients remained ventilator-dependent at discharge.
Conclusion: Spine fractures and spinal cord injuries caused by mountain biking accidents typically affect young, male, recreational riders. The medical, personal, and societal costs of these injuries are high. Injury prevention should remain a primary goal, and further research is necessary to explore the utility of educational programs, and the effect of helmets and other protective gear on spine injuries sustained while mountain biking.
