Seatbelts and the Risk of Auto Injury

Orthopedic surgeons and neurosurgeons at the Medical College of Wisconsin see a lot of spine injuries in patients who have been in an auto accident. You may not be aware of it, but the leading cause of spine injuries in your midback (thoracic) and low back (lumbar) areas is auto accidents.

In a study, doctors evaluated records of 4572 patients between 1996 and 2011 entered into the Crash Injury Research and Engineering Network database who were moderately to severely injured in an auto accident. They looked for what these patients had in common.

Of 631 patients who had injuries to the thoracic and lumbar spine, almost 47% of the patients had major injuries while 53% had minor injuries. These injuries could be categorized as flexion-distraction injuries where the person has had an injury from the upper body and head moving towards their knees in the auto accident, or extension injuries where the body bends backward.

If the auto accident caused a flexion-distraction injury, the victim was usually a child or young adult. Those suffering from extension injuries were usually older adults with an average age of 65 years old, and were overweight. The auto accidents that caused extension injuries were the worst, as the fatality rate was almost 24%. Other auto accidents had a fatality rate of about 11%.

The doctors discovered that if the auto accident caused minor injuries to the thoracic and lumbar spine, the patients' injuries were worse. This was because they were usually abdominal and pelvic injuries.

Seatbelt use

Interestingly, there was a difference between those who used a two-point belted seatbelt versus a three-point belted seatbelt. The three-point seat belts protected against neurological injury, fatality, and worse injuries. However, in the auto accident, those who were wearing the three-point seatbelts were more than three times more likely to have fractures of the spine than with the two-point seatbelts. Those who used two-point belted seatbelts had flexion-distraction injuries most of the time. Those who didn't wear a seatbelt at all had a higher risk of having spinal fractures in the thoracic and lumbar areas as well as dislocations.

This tells us that in an auto accident, using seatbelts will reduce injury severity of mortality but at the same time, it will also increase the likelihood of a vertebrae fracture in the thoracic and lumbar spine.

If you have been injured in an auto accident, seek proper medical and chiropractic care. Utilizing both together will help speed your recovery.


Rao, R.D., et al. Occupant and crash characteristics in the thoracic and lumbar spine injuries resulting from motor vehicle collisions. Spine Journal 2014.