Body Morphology and Its Associations with Thoracolumbar Trauma Sustained in Motor Vehicle Collisions

Document Type

Journal Article

Publication Date



Journal of the American Academy of Orthopaedic Surgeons








body mass index; motor vehicle collision; obesity; spine; thoracolumbar fractures


© 2015 by the American Academy of Orthopaedic Surgeons. Objective: This study investigates the relationship between body mass index (BMI) and the patterns of thoracolumbar spinal fractures sustained by patients in motor vehicle collisions (MVCs). Design: The Crash Injury Research and Engineering Network (CIREN) database was used to analyze prospective data on patients involved in MVCs of moderate severity. Methods: Thoracolumbar fractures in 631 subjects were analyzed for patient-, vehicle-, and crash-related factors. Spine injuries were classified according to a modified Denis classification system. Subjects were stratified into BMI subgroups that were then analyzed by injury level, fracture pattern, associated systemic injury, and mortality. Results: Obesity (BMI ≥30.0) was found to be associated with a more cephalad level of injury. Mean BMI was higher in 67 patients with fatal outcomes compared with 557 survivors. Patients who sustained a thoracolumbar fracture and another system injury were more likely to be overweight and obese. Among the various fracture patterns analyzed, BMI was highest in patients with extension injuries. Conclusion: This study characterizes the relationship between body morphology and the thoracolumbar injury patterns associated with MVC to improve understanding of the overall morbidity and mortality of these injuries. These results corroborate research demonstrating the unique relationships between patients who are obese and specific patterns of injury and higher injury severity caused by MVCs and establish a rationale for specifically including thoracolumbar spine parameters in crash safety standards.

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