Frequency of acute cervical and lumbar pathology in common types of motor vehicle collisions: a retrospective record review

BACKGROUND There are more than 5 million motor vehicle collisions annually in the United States, resulting in more than 2 million injured occupants. The most common types of collisions are head-on impacts, rear-ends, side-swipes, and t-bones, whilst the most common injury sites are the cervical and lumbar spine. The purpose of this retrospective record review was to examine the differences in frequency of cervical and lumbar pathology across and between these common collision types. METHODS Nine-hundred and three patients were included in this analysis, 88 of whom described being in a head-on collision, 546 in a rear-end, 123 in a side-swipe, and 146 in a t-bone. Four diagnoses were examined, two each for the cervical and lumbar regions: disc derangement and radiculitis. Pearson's Chi-squared contingency tables were used to test whether there were differences in clinical diagnosis frequencies across collision type, while Marascuilo's post hoc multiple proportion comparisons were conducted to determine inter-group differences. RESULTS There were significant differences across collision type for cervical disc derangement (p < 0.0001), cervical radiculitis (p < 0.00001), lumbar disc derangement (p = 0.0002) and lumbar radiculitis (p < 0.00001). There were also significant differences in pathology frequency between collision types. CONCLUSIONS Symptomatic cervical disc derangements were more common among patients who were involved in aside-swipe, whereas symptomatic lumbar disc derangements were more common among those in head-on or side-swipe collisions. Expanded controlled prospective studies are encouraged to better understand the mechanisms of injury and determine radiculitis tolerance limits.