Tehran, Iran

Author Affiliations: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran (Rasouli MR, Rahimi-Movaghar V, Maheronnaghsh R, Yousefian A); Research Centre for Neural Repair, University of Tehran, Tehran, Iran (Rahimi-Movaghar V); Department of Orthopaedics and Neurosurgery, Thomas Jefferson University and the Rothman Institute, Philadelphia, PA, USA (Rasouli MR, Vaccaro AR)

Corresponding Author: Vafa Rahimi-Movaghar, MD, Associate Professor of Neurosurgery, Sina Trauma and Surgery Research Center, Sina Hospital, Hassan-Abad Square, Imam Khomeini Ave, Tehran University of Medical Sciences, Tehran, 11365-3876, Iran (Tel: (+98) 915 342 2682, (+98) 216 671 8311; Fax: (+98) 216 670 5140; Email: v_rahimi@sina.tums.ac.ir; v_rahimi@yahoo.com)

doi: 10.1007/s12519-011-0327-z

Background: Spinal cord injury (SCI) is a devastating event that results in permanent disability for injured children. Among all etiologies of SCI, motor vehicle crashes (MVCs) are the leading cause and account for 29% of all traumatic SCIs in children. We tried to evaluate types and mechanisms of MVC-related spinal column and spinal cord injuries, risk factors, safety issues and legislation.

Data sources: A literature review was performed using PubMed from 1966 to 12th April 2010 with the following key words: children OR pediatric, spine, injury OR trauma, restraint, seat belt, motor vehicle, road OR traffic, collision OR crash, safety. Cross referencing of discovered articles was also performed.

Results: Risk factors for MVC-related SCI include single vehicle crashes, vehicle rollover, and ejection of the passenger from the vehicle. Any anatomic region of the spinal cord may be injured as a result of MVC and may vary according to the type of accident and restraint system usage. Increasing use of three-point seat belts, which are more protective than isolated lap seat belts, has decreased the incidence of MVC-related SCI. There is evidence that airbag use without seatbelt use is associated with an increased risk of cervical spine fractures with or without SCI. Vehicle designers need to give more attention to the prevention of vehicle rollover and to improve occupant protection when rollover occurs.

Conclusions: MVC is a common cause of SCI in children; therefore, paying attention to risk factors and modes of prevention is important. As MVC-related SCI can lead to permanent disability, prevention and education play an important role in decreasing childrens' morbidity and mortality. Making behavior, roads and vehicles safer can significantly reduce MVC-related SCI in children.

Key words: children; injury; motor vehicle crash; spinal cord

                  World J Pediatr 2011;7(4):311-317