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Brian Claytor, MD, Paul MacLennan,
PhD, Gerald McGwin, Jr., PhD, Loring Rue, MD, John Kirkpatrick,
MD
Content - Motor vehicle collision
(MVC) related cervical spine injury is a severe and often
permanently disabling injury. Although advances in automobile
crashworthiness have reduced both fatalities and some severe
injuries, the impact of varying occupant restraint systems
(seatbelts and airbags) on cervical spine injury is unknown.
Objective - To investigate the
relationship between the occurrence of cervical spine injury
and occupant restraint systems among front seat occupants
involved in frontal MVCs.
Design, Setting, and Patients -
A case-control study among subjects obtained from the 1995
to 2001 National Automotive Sampling System (NASS). Cases
were identified based on having sustained a cervical spine
injury of $2
on the Abbreviated Injury Scale, 1990 Revision.
Results - Approximately half
(44.7%) of 8,412 cases of cervical spine injury were unrestrained
occupants while belted only, airbag only and both restraint
systems represented 38.2%, 8.8% and 8.4% of cases respectively.
Overall, the combined use of airbag and seatbelt had the greatest
protective effect, relative to unrestrained occupants, with
an odds ratio (OR) of 0.19 and a 95% confidence interval (CI)
of 0.12 to 0.30. Use of a seatbelt only also had a protective
effect (OR=0.40, 95% CI=0.23 to 0.70). Occupant use of an
airbag only neither increased nor decreased the risk of cervical
spine injuries relative to unrestrained occupants (OR=1.02,
95% CI=0.57 to 2.13).
Conclusions - The results of
this study suggest that there is an increase in overall protection
against cervical spine injury by combining airbag and seatbelt
restraint systems relative to seatbelt alone.
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