The dominance of vertebral column fractures associated with neurologic deficits among survivors of light-plane accidents.

The vertebral injuries sustained by 13 survivors of four light-plane crashes were reviewed. Eight patients sustained major nonvertebral injuries. Eleven patients sustained 18 lower thoracic and/or upper lumbar fractures. Eighty-five per cent of the fractures involved T12, L1, L2, or L3. Seven patients sustained vertebral burst fractures; ten sustained vertebral flexion fractures. In nine patients these vertebral fractures had associated fracture-dislocations of the posterior pedicles. Eight of these nine patients (89%) developed neurologic deficits of the conus medullaris and/or cauda equina. The severity and time of onset of these neurologic deficits were similar for the occupants of each aircraft. Downward vertical deceleration and rotational violence were the dominant forces which inflicted the vertebral column fractures which resulted in neurologic deficits.