Spine fractures caused by horse riding

Abstract

Study design: Retrospective study and review of literature.

Objectives: Study of demographic data concerning spinal fractures caused by horse riding, classification of fractures according to the AO and Load Sharing classifications, evaluation of mid-term radiological results and long-term functional results.

Methods: A review of medical reports and radiological examinations of patients presented to our hospital with horse riding-related spine fractures over a 13-year period; long-term functional follow-up is performed using the Roland Morris Disability Questionnaire (RMDQ-24).

Results: Thirty-six spine fractures were found in 32 patients. Male to female ratio is 1:7. Average age is 33.7 years (8-58 years). The majority of the fractures (78%) are seen at the thoracolumbar junction Th11-L2. All but two patients have AO type A fractures. The average Load Sharing Classification score is 4.9 (range 3-9). Neurological examinations show ASIA/Frankel E status for all patients. Surgical treatment is performed on ten patients. Mean follow-up for radiological data is 15 months (range 3-63). Functional follow-up times range from 1 to 13 years with an average follow-up of 7.3 years. Mean RMDQ-24 score for all patients is 5.5 (range: 0-19), with significantly different scores for the non-operative and surgical group: 4.6 vs 8.1. Twenty-two percent of the patients have permanent occupational disabilities and there is a significant correlation between occupational disability and RMDQ-24 scores.

Conclusions: Not only are short-term effects of spine fractures caused by horse riding substantial but these injuries can also lead to long-term disabilities.

Fig. 1

a Local sagittal angle. b Regional sagittal angle

Fig. 2

Fracture levels; total number of 36 fractures

Fig. 3

MRI of patient with AO type B 1.2 fracture showing a lesion of the posterior ligamentary complex between the spinous processes of Th11 and Th12, a peridural hematoma and a compression fracture of the upper endplate of Th12

Fig. 4

History of kyphosis in non-operatively treated group and surgically stabilized group; T1 hospital admission, T2 1–3 months and T3 9–12 months (after posterior implant removal)