Seat-belt use and relation to neurologic injury in motor vehicle crashes.

The relation between seat-belt use and neurologic injury was examined for the 1,352 patients who had spinal injuries as the result of motor vehicle crashes and were subsequently admitted to the Midwest Regional Spinal Cord Injury Center at Northwestern University between 1971 and 1993. Intact lesions were observed in 44% of patients (Frankel level E), complete lesions in 28% (Frankel A), sensory intact lesions in 8% (Frankel B), motor intact lesions in 5% (Frankel C), and functional motor lesions in 14% (Frankel D). Whereas only 14% of the sample were wearing seat belts, 60% of the belted and 41% of the unbelted vehicle occupants had intact lesions. The odds of surviving a motor vehicle crash with an intact injury were greater for patients who were wearing a lap or shoulder belt (odds = 1.57) for women (odds = 0.63) and for patients whose injury occurred more recently (odds = 1.05). The relation between position in the vehicle and extent of injury was strongest for rear passengers: intact lesions were sustained by 73% of belted and 35% of unbelted rear passengers, whereas complete lesions were sustained by 9% of the belted and 21% of the unbelted rear passengers. In conclusion, seat belts appear to be an effective means of decreasing the extent of neurologic deficit in those sustaining spinal injuries caused by motor vehicle crashes. The results of this study support injury-prevention efforts that emphasize lap- and shoulder-belt use.