Cycling was the number one cause of sporting-related cervical fractures among men, while horseback riding topped the list among women. The most common cause of cervical spine injury in the United States was football, with the majority of those injuries being sprains.
Study results were presented during the 2018 annual meeting of the American Academy of Orthopaedic Surgeons.
Researchers from Brown University, who performed the study, also note that sporting-related cervical fractures increased by 35% from 2000 to 2015, mainly due to an increase in cycling-related injuries.
In their study, the researchers used the National Electronic Injury Surveillance System (NEISS) database to estimate the sex-specific incidence of cervical spine injuries in sporting activities and to identify the activities most commonly associated with neck sprains and cervical fractures.
The NEISS database, which is managed by the Consumer Product Safety Commission (CPSC), collects information on emergency room patients from 100 US hospitals.
According to a media release from AAOS, the study authors identified 27,546 patients who sustained a neck injury during a sporting activity. Among these patients, the authors found that, overall, the number of neck sprains decreased by 33% from 2000 to 2015; however, sprains sustained during weightlifting and aerobic exercise increased by 66%.
In addition, sporting-related cervical fractures increased by 30% in that time period, which was driven in part by a 300% increase in cycling-related injuries. The incidence of injuries in males was 1.7 times higher for neck sprains and 3.6 times greater for fractures when compared to females.
The most common causes of neck sprains overall were football, followed by weightlifting/aerobics, cycling, trampoline, and diving/swimming.
Football was the most common cause of cervical sprains in men, followed by cycling and weightlifting/aerobics. Cycling caused the most fractures in males, followed by diving/swimming and football.
Women experienced the most neck sprains during weightlifting/aerobics, trampoline, and cheerleading. Horseback riding caused the most cervical fractures in females, followed by cycling and diving/swimming.
“Cervical spine injury is a substantial cause of morbidity and mortality, and, as far as injuries go, one of the more devastating injuries that we as orthopaedic surgeons can treat,” says lead study author J. Mason DePasse, MD, orthopaedic trauma surgery fellow at Brown University, in the release.
“There isn’t much data available on spine/neck injuries in recreational activities and sports. The most recent paper we quoted was from 1991 and looked only at 63 male patients. In our study, we were able to sort through more than 50,000 cases by utilizing data analytics, which would have been nearly impossible to sift through by hand. The biggest takeaway was that cycling is the number one cause of neck fractures, which suggests we may need to investigate this in terms of safety.”
In addition, the study suggests that while football remains the main cause of cervical injuries in the US, it was primarily associated with sprains and the overall incidence of football-related injuries decreased. The researchers hypothesized that this could be due to better protective equipment and safety rules. It also could be due to the increased use of computed tomography, which has resulted in an increased diagnosis of cervical spine fractures that may have been previously diagnosed as a sprain.
The team used SAS 9.4 for analysis and built algorithms involving string recognition and automated text analysis that went through the over 50,000 patient cases. Patients were preliminarily included based on specific criteria, including association with recreational activity, diagnosis code indicating fracture or strain/sprain, and body part indicating neck region. Repeated testing and algorithm refinement was utilized to exclude irrelevant cases. Statistical significance was defined as p<0.05, the release continues.
[Source(s): American Academy of Orthopaedic Surgeons, PR Newswire]