Ski and Snowboard-Related Spinal Trauma and Spinal Cord Injury: A Northeastern Level I Trauma Experience.

Abstract

Study design: Retrospective review.

Objective: To review the traumatic spinal injuries in alpine athletes treated at a single level I trauma center.

Summary of background data: Recreational and competitive skiers/snowboarders are prone to spinal injuries, and recent changes in the sport may have led to increases in the incidence and severity of spinal injuries. Currently, there is a paucity of data on the epidemiology of spinal injuries resulting from skiing and snowboarding.

Methods: A review of patients admitted with traumatic spinal injuries from skiing/snowboarding, between January 2015 and March 2019. Data on demographics, spinal region of injury, mechanism of injury, fracture type, presence/absence of spinal cord injury, ASIA score, management, concomitant injuries, and involvement of other surgical services were collected.

Results: Spinal injuries were distributed as 33.3% cervical, 57% thoracic, and 38.0% lumbosacral spine. Seventy-five percent patients injured a single region, 21.7% injured 2 regions, and 3.3% injured all 3. Single-level injuries occurred in 38% patients, II-level in 25%, III-level in 12%, and >3-levels in 28%. Twenty-seven percent patients suffered a spinal cord injury. Eighty-one percent of those had neurological compromise, with a 53.8% rate of full neurological resolution at the time of discharge. 65% fractures were compression-type. Management included operative treatment with decompression and fusion in 32% patients. Cervical spinal injuries were more likely to sustain an extension-distraction type fracture and concomitant spinal cord injury. Thoracic spine injuries were more likely to have multiple vertebral level (>3 vertebrae) involvement. Lumbosacral injuries were more likely to sustain compression type and transverse process fractures. Patients with trauma to all 3 spinal regions were more likely to have translational/rotational injuries, facet fractures, lamina and pedicle fractures, and traumatic anterolistheses.

Conclusion: Skiing/snowboarding injuries can be devastating, potentially resulting in permanent neurological compromise and spinal instability. Surgeons and the general population can benefit from improving their understanding of the dangers of alpine sports as it pertains to spinal trauma.