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Two wheel motorized vehicles used in both street transportation and recreation are a common cause of severe injury in the United States (US). To date, there has been limited data describing the spinal injury patterns among these motorcycle injury patients in the US. The goal of this study is to characterize and compare differences in specific injury patterns of patients sustaining traumatic spinal injuries after motocross (off-road) and street bike (on-road) collisions in the southwestern US at a Level I Trauma Center. Trauma registry data was queried for patients sustaining a spinal injury after motorcycle collision from 2010 to 2019 at a single Level I Trauma Center. Computed tomography (CT) scan and magnetic imaging resonance imaging (MRI) reports from initial trauma evaluation were reviewed and data was manually obtained regarding injury morphology and location. A total of 1798 injuries were identified in 549 patients who sustained a motorcycle collision, specifically 67 off-road and 482 on-road motorcycle patients. Off-road motorcycle patients were found to be significantly younger (34.75 vs. 42.66,  p = 0.00015 ). A total of 46.2% of the off-road injuries were determined to be from compression mechanisms, compared to 32.9% in the on-road cohort ( p = 0.0027 ). The on-road cohort was more likely to have an injury classified as insignificant, such as transverse and spinous process fractures (60.1% vs. 42.5%,  p = 00.25 ). There was no significant difference in regards to junctional, mobile, and semirigid spine segments between the two cohorts. Different fracture patterns were seen between the off-road and on-road motorcycle cohorts. Off road motorcyclists experienced significantly more compression and translational injuries, while on road motorcyclists experienced more frequent insignificant injury patterns. Data on the different fracture patterns may help professionals develop safety equipment for motorcyclists.

Traumatic spinal injury patterns of on vs. off-road motorcycle crashes