Motorcycle Helmets and Spinal Injuries: Dispelling the Myth

Study objective: To determine the relationship between spinal injuries and helmet use in motorcycle trauma. Design: Retrospective case series. Setting: Twenty-eight hospitals in four midwestern states–Illinois, Iowa, Nebraska and Wisconsin–representing urban, suburban, and rural settings. Patients and other participants: Consecutive sample of motorcyclists treated at the participating centers. Interventions: None. Main outcome measures: The major variables evaluated were helmet use, ethanol use, and significant head or spinal injuries. Results: 1,153 cases were analyzed. Helmet use was not significantly associated with spinal injuries (odds ratio, 1.12; 95% confidence intervals, 0.79, 1.58) whereas head injury was markedly decreased with helmet use (odds ratio, 0.35; 95% confidence intervals, 0.23, 0.53). Ethanol use was a significant variable in both head (odds ratio, 3.89) and spinal (odds ratio, 2.41) injuries. Conclusion: In contrast to a significant protective relationship identified for head injuries, helmet use was not associated with an increased or decreased occurrence rate of spinal injuries in motorcycle trauma. [Orsay EM, Muelleman RL, Peterson TD, Jurisic DH, Kosasih JB, Levy P: Motorcycle helmets and spinal injuries: Dispelling the myth. Ann Emerg Med April 1994;23:802-806.]