Severe Spinal Injuries In Alpine Skiing And Snowboarding: A six-year review of Tertiary Trauma Center for the Bernese Alps Ski Resorts, Switzerland

Torsten Franz ^1*, Rebecca M. Hasler ², Lorin Benneker ¹, Heinz Zimmermann ², Klaus A. Siebenrock ¹ and Aristomenis K. Exadaktylos ²

¹ University of Bern, Department of Orthopedic Surgery, Inselspital Bern, Switzerland
² University of Bern, Department of Emergency Medicine, Inselspital, Bern, Switzerland

^* To whom correspondence should be addressed. E-mail: tfranz_so{at}spital.ktso.ch.

Accepted 22 May 2007

Abstract

OBJECTIVE: To analyze the epidemiological data, injury pattern, clinical features and mechanisms of severe spinal injuries related to alpine skiing and snowboarding.

STUDY DESIGN: A six-year review of all adult patients with severe spinal injuries sustained from alpine skiing or snowboarding.

SETTING: Tertiary trauma center in Bern, Switzerland.

PATIENTS AND METHODS: All adult patients (over 16 years of age) admitted to a tertiary trauma center from July 1, 2000, through June 30, 2006, were reviewed using a computerized database. From these records, a total of 728 patients injured from snow sports were identified. Severe spinal injuries (defined as spinal fractures, subluxations, dislocations, or concomitant spinal cord injuries) were found in 73 patients (17 female, 56 male). The clinical features of these patients were reviewed with respect to epidemiologic factors, mechanism of injury, fracture pattern, and neurological status.

RESULTS: The majority of severe spinal injuries (n = 63) were related to skiing. Fatal central-nervous injuries and transitory or persistent neurological symptoms occurred in 28 patients (23 skiers, 5 snowboarders). None of the snowboarders suffered from persistent neurological sequelae. Snowboarders with severe spinal injury (n = 10) were all male (p < 0.05), and were significantly younger than skiers (p < 0.001). The most commonly affected site was the lumbar spine. However, 39 patients (53.4%) suffered from injury pattern at two or more levels.

CONCLUSIONS: With advances in technology and slope maintenance, skiers and snowboarders progress to higher skill levels and faster speeds more rapidly than ever before. Great efforts have been focused on reducing extremity injuries in snow sports, but until recently very little attention has been given to spinal injury prevention on the slopes. Suggestions for injury prevention include the use of spine protectors, participation on appropriate runs for ability level, proper fit and adjustment of equipment, and taking lessons with the goal of increasing ability and learning hill etiquette.

Key Words: Skiing, Snowboarding, Spinal Injuries, Sports Trauma, Vertebral Fractures

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