Loder Randall T, Walker Alyssa L, Blakemore Laurel C
Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Department of Orthopaedic Surgery, George Washington University School of Medicine, Washington, DC 22031, USA.
J Clin Med. 2025 Jun 26;14(13):4521. doi: 10.3390/jcm14134521.
Equestrian activities can result in spine injuries. Most studies are from single centers, and none use a national database. It was the purpose of this study to describe the demographics, injury mechanisms, and types of equestrian-associated spinal injuries using a US national ED database. The National Electronic Injury Surveillance System database was queried for equestrian-related spine injuries from 2000-2023. ED disposition was categorized as discharged or not discharged. Statistical analyses accounted for the weighted, stratified nature of the data to obtain national estimates. There were an estimated 54,830 patients, having an average age of 42 years. Most were female (73.6%) and White (93.7%); one-half (51.1%) were not discharged from the ED. The spine level was the lumbar (49.1%), thoracic (24.4%), sacrococcygeal (15.5%), and cervical (11.0%) spine. Multiple spine fractures occurred in 4.0%. A simple fall off a horse occurred in 53.6% of the injuries, and the patient was bucked/thrown/kicked off the horse in 39.7%. Neurologic injury was rare (1.8%). Hospital admission was highest in the cervical group (74.3%) and lowest in the sacrococcygeal group (33.5%). The cervical group had the highest percentage of males (43.7%) compared to the thoracic, lumbar, and sacrococcygeal groups (22.8%, 27.3%, 16.8%, respectively). There were proportionally fewer females in those over 50 years of age, where the male percentage was 11.7%, 25.6%, and 31.6% for those <18 years, 18-50 years, and >50 years old, respectively. This large study can be used as baseline data to evaluate further changes in equestrian injuries, especially the impact of further prevention strategies, education protocols, and legislative/governmental regulations of public equestrian localities.
马术活动可能导致脊柱损伤。大多数研究来自单一中心，且均未使用国家数据库。本研究的目的是利用美国国家急诊数据库描述马术相关脊柱损伤的人口统计学特征、损伤机制和类型。查询了国家电子伤害监测系统数据库中2000年至2023年与马术相关的脊柱损伤情况。急诊处置分为出院或未出院。统计分析考虑了数据的加权、分层性质以获得全国估计数。估计有54830名患者，平均年龄42岁。大多数为女性（73.6%）和白人（93.7%）；一半（51.1%）未从急诊室出院。脊柱损伤部位为腰椎（49.1%）、胸椎（24.4%）、骶尾椎（15.5%）和颈椎（11.0%）。4.0%的患者发生多处脊柱骨折。53.6%的损伤是简单地从马背上摔落，39.7%的患者是被马甩下/踢下/扔下。神经损伤很少见（1.8%）。颈椎组住院率最高（74.3%），骶尾椎组最低（33.5%）。与胸椎、腰椎和骶尾椎组（分别为22.8%、27.3%、16.8%）相比，颈椎组男性比例最高（43.7%）。50岁以上女性比例相对较少，18岁以下、18至50岁和50岁以上男性比例分别为11.7%、25.6%和31.6%。这项大型研究可作为基线数据，以评估马术损伤的进一步变化，特别是进一步预防策略、教育方案以及公共马术场所立法/政府法规的影响。
