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Spinal injury in motor vehicle crashes: elevated risk persists up to 12 years of age
  1. J Brown,
  2. L E Bilston
  1. Prince of Wales Medical Research Institute, University of New South Wales, Sydney, Australia
  1. Julie Brown, Prince of Wales Medical Research Institute, UNSW, Barker St, Randwick, NSW 2031, Australia; Julie.Brown{at}


Objective: To determine whether age is associated with serious spinal injury in paediatric motor vehicle occupants, after controlling for crash-related factors.

Design and Setting: Retrospective record review.

Patients and Outcome Measures: All motor vehicle passengers aged 0–16 years treated at two major children’s hospitals from 1999 to 2004 with ICD-10 codes for spinal trauma. Injury outcomes were categorised as minor and serious. Minor injuries were analogous to AIS 1 injuries. Serious injuries were those that posed some risk to the integrity of the spinal column or cord.

Results: 72 cases were identified (58 <12 years of age, 14 ⩾12 years of age). Using logistic regression to adjust for confounders, including crash severity and crash type, age <12 years was found to be significantly associated with serious spinal injury. Compared to older children, children aged less than 12 years were more likely to sustain serious spinal injury (OR 7.1, 95% CI 1.2 to 42.9).

Conclusion: Children up to age 12 have an elevated risk of serious spinal injury in car crashes. This age breakpoint may reflect the adequacy of seat belt fit, and use of adult seatbelts alone before age 12 may increase a child’s risk of serious spinal injury. An association between age and serious spinal injury should also be considered in the triage of paediatric motor vehicle occupants.

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  • Funding: This work was supported by a research grant from the NSW Motor Accidents Authority. LB is supported by an NHMRC senior research fellowship.

  • Competing interests: None.

  • Ethics approval: The study was approved by the Human Ethics Committees at both hospitals, and the University of New South Wales.