[Impact of Spinal Fractures in Horseback Riding].

Abstract: Injuries to the spinal cord are not only dreaded because of the high risks existing during the acute phase, but also because of their potential long-term sequelae. Horseback riding also poses a high risk of spinal injuries. We therefore evaluated the most frequent characteristics of accidents leading to long-term sequelae, the primary long-term discomfort resulting from such injuries caused by horseback riding accidents and the way injured persons changed their behaviour after the accidents. Methods: Our study included all cases of horseback riding injuries registered in the Department of Trauma, Hand, Plastic and Restorative Surgery at the University Hospital of Ulm between May 2005 and October 2012. Sequelae of the accidents were examined via follow-up interviews by phone. These included questions about protective gear worn during the accident as well as behavioural changes after the injury. In addition, a spine-specific questionnaire based on the Visual Analogue Scale (VAS) was used to assess long-term complications. Results: Overall, we recorded 50 cases of spinal injuries caused by horseback riding accidents over a time span of 7 years and 5 months. 41 (82 %) of the patients were female and 9 (18 %) were male. The average patient age was 32.0 ± 15.2 years. All in all, the 50 patients sustained 84 injuries: 59 fractures and 25 other injuries such as distorsions or discoligamentous injuries. Most injuries were located in the lumbar spine (n = 43), corresponding to 51 % of all recorded injuries, followed by 32 % in the thoracic spine (n = 27) and 17 % in the cervical spine (n = 14). After sustaining a fracture to the spine, 9 out of 24 patients quit horseback riding. All patients used a helmet after the accident, but only 7 out of 15 used back protection. 11 out of 24 patients suffer from back pain while resting with a mean VAS score of 3.4 ± 1.9. More than half (17 out of 24) have back pain while working with a VAS score of 4.8 ± 2.2. Conclusions: The frequency and severity of back injuries sustained by horseback riders increases with age. This can be due to various reasons such as biomechanical factors. The low acceptance of back protection is remarkable.