Purpose: Multiple studies have described the general injuries associated with mountain biking. However, no detailed assessment of mountain biking associated spinal column fractures and spinal cord injuries (SCI) has previously been reported. The purpose of this study is to describe the patient demographics, injuries, mechanisms, treatments, outcomes and resource requirements associated with spine injuries sustained while mountain biking.

Method: Patients who were injured while mountain biking, and presented to a provincial spine referral centre between 1995 and 2007 inclusive, with SCI and/ or spine fracture were included. A chart review was performed to obtain demographic data, and details of the injury, treatment, outcome and resource requirements.

Results: 102 men and 5 women were identified for inclusion. The mean age at injury was 32.7 years 95%CI[30.6,35.0]. 79 patients (73.8%) sustained cervical injuries, while the remainder sustained thoracic or lumbar injuries. 43 patients (40.2%) sustained a SCI. Of those with cord injuries, 18(41.9%) were ASIA A, 5(11.6%) were ASIA B, 10(23.3%) ASIA C, and 10(23.3%) ASIA D. 67 patients (62.6%) required surgical treatment. The mean length of stay in an acute hospital bed was 16.9 days 95%CI[13.1,30.0]. 33 patients (30.8%) required ICU care, and 31 patients (29.0%) required inpatient rehabilitation. Of the 43 patients (39.6%) who presented with SCI, 14(32.5%) improved by one ASIA category, and 1 (2.0%) improved by two ASIA categories. Two patients remained ventilator-dependent at discharge.

Conclusion: Spine fractures and SCI due to mountain biking accidents typically affect young, male, recreational riders. The medical, personal, and societal costs of these injuries are high. Injury prevention should remain a primary goal, and further research is necessary to explore the utility of educational programs, and the impact of helmets and other protective gear on spine injuries sustained while mountain biking.