Eng Svend Filip, Næss Ingar, Linnerud Hege, Rønning Pål, Brommeland Tor, Evjensvold Magnus, Sundstrøm Terje, Galteland Pål, Døving Mats, Aarhus Mads, Helseth Eirik, Ramm-Pettersen Jon
Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
N Am Spine Soc J. 2022 Apr 30;10:100119. doi: 10.1016/j.xnsj.2022.100119. eCollection 2022 Jun.
Bicyclists are vulnerable road users. The aim of this paper was to describe all bicycle-related traumatic cervical spine injuries (CSIs) in the South-East region of Norway (2015-2019), and to investigate whether certain types of CSIs are typical for bicyclists.
Retrospective cohort study of prospectively collected registry data of all CSIs in the South-East region of Norway (3.0 million inhabitants), from 2015 to 2019. Patient characteristics, injury types, and treatment were summarized with descriptive statistics. Bayesian multivariable logistic regression was used to identify potential factors associated with occipital condyle fractures (OC-Fx) or odontoid fractures (OFx).
During the five-year study period, 2,162 patients with CSIs were registered, and 261 (12%) were bicycle-related. The incidence of bicycle-related CSIs was 1.7/100,000 person-years. The median age of the patients with bicycle-related CSIs was 55 (IQR: 22) years, 83% were male, 71% used a helmet, 16% were influenced by ethanol, 12% had a concomitant cervical spinal cord injury (SCI), and 64% sustained multiple traumas. The three most common bicycle-related CSIs were C6/C7 fracture (Fx) (28%), occipital condyle Fx (OC-Fx) (23%) and C5/C6 Fx (19%). Patients with bicycle-related CSIs compared to patients with non-bicycle related CSIs were younger, more often male, had fewer comorbidities, more likely multiple traumas, more often had OC-Fx, and less often sustained an odontoid fracture (OFx). Multivariable logistic regression of potential risk factors for OC-Fx demonstrated a significantly increased risk of OC-Fx for bicyclists compared to non-bicyclists (OR=2.8).The primary treatment for bicycle-related CSIs was external immobilization in 187/261 (71.6%) cases, open surgical fixation in 44/261 (16.8%), and no treatment in 30/261 (11.5%).
Bicycle crashes are a frequent cause of CSIs in the Norwegian population and should be of concern to the public society. The three most common bicycle-related CSIs were C6/C7 fracture, occipital condyle fracture and C5/C6 fracture.
骑自行车的人是道路上的弱势群体。本文旨在描述挪威东南部地区（2015 - 2019年）所有与自行车相关的创伤性颈椎损伤（CSI），并调查某些类型的CSI是否为骑自行车者所特有。
对挪威东南部地区（300万居民）2015年至2019年前瞻性收集的所有CSI登记数据进行回顾性队列研究。用描述性统计总结患者特征、损伤类型和治疗情况。采用贝叶斯多变量逻辑回归来确定与枕髁骨折（OC - Fx）或齿状突骨折（OFx）相关的潜在因素。
在为期五年的研究期间，登记了2162例CSI患者，其中261例（12%）与自行车相关。与自行车相关的CSI发病率为1.7/100,000人年。与自行车相关的CSI患者的中位年龄为55岁（四分位间距：22岁），83%为男性，71%使用头盔，16%受乙醇影响，12%伴有颈脊髓损伤（SCI），64%遭受多发伤。三种最常见的与自行车相关的CSI是C6/C7骨折（Fx）（28%）、枕髁骨折（OC - Fx）（23%）和C5/C6骨折（19%）。与非自行车相关的CSI患者相比，与自行车相关的CSI患者更年轻，男性更常见，合并症更少，多发伤更常见，更常发生OC - Fx，而齿状突骨折（OFx）较少见。OC - Fx潜在危险因素的多变量逻辑回归显示，与非骑自行车者相比，骑自行车者发生OC - Fx的风险显著增加（OR = 2.8）。与自行车相关的CSI的主要治疗方法是187/261（71.6%）例采用外部固定，44/261（16.8%）例采用开放手术固定，30/全部261（11.5%）例未进行治疗。
自行车事故是挪威人群中CSI的常见原因，应引起社会公众的关注。三种最常见的与自行车相关的CSI是C6/C7骨折、枕髁骨折和C5/C6骨折。
