Korean J Neurotrauma.  2015 Oct;11(2):195-200. 10.13004/kjnt.2015.11.2.195.

Three Cases of Spine Fractures after an Airplane Crash

• Lee HJ
• Moon BJ
• Pennant WA
• Shin DA
• Kim KN
• Yoon DH
• Ha Y

• KMID: 2378287
• DOI: http://doi.org/10.13004/kjnt.2015.11.2.195

Abstract

While injuries to the spine after an airplane crash are not rare, most crashes result in fatal injuries. As such, few studies exist that reported on spine fractures sustained during airplane accidents. In this report, we demonstrate three cases of spine fractures due to crash landing of a commercial airplane. Three passengers perished from injuries after the crash landing, yet most of the passengers and crew on board survived, with injuries ranging from minor to severe. Through evaluating our three spine fracture patients, it was determined that compression fracture of the spine was the primary injury related to the airplane accident. The first patient was a 20-year-old female who sustained a T6-8 compression fracture without neurologic deterioration. The second patient was a 33-year-old female with an L2 compression fracture, and the last patient was a 49-year-old male patient with a T8 compression fracture. All three patients were managed conservatively and required spinal orthotics. During the crash, each of these patients were subjected to direct, downward high gravity z-axis (Gz) force, which gave rise to load on the spine vertically, thereby causing compression fracture. Therefore, new safety methods should be developed to prevent excessive Gz force during airplane crash landings.

Keyword

Fractures, compression; Spinal fractures; Back pain; Accidents, aviation

MeSH Terms

Accidents, Aviation
Adult
Aircraft*
Back Pain
Female
Fractures, Compression
Humans
Hypergravity
Male
Middle Aged
Spinal Fractures
Spine*
Young Adult

Figure

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  FIGURE 1 Wreckage of the airplane crash. The tail of the plane hit the runway while landing.

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  FIGURE 2 The seat plan of the airplane. The first patient was seated in the rear of the aircraft. The second patient was seated toward the front. The last patient was seated in the front of the aircraft (from ASIANA airline home page http://www.flyasiana.com).

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  FIGURE 3 Two white arrows as shown in the thoracic spinal X-ray (A) implicated compression fractures on the anterior upper portion of the T6 and T7 vertebral bodies. Sagittal computed tomography (CT) image (B) showed fractures on the upper portion of the T6 to T8 vertebral bodies (white arrows), and axial CT image (C) revealed linear oblique fracture (arrow). T1 gadolinium enhanced sagittal magnetic resonance image (D) showed high signal intensities with enhancement at the T6 to T8 vertebral bodies (arrows).

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  FIGURE 4 X-ray (A) showed anterior wedge compression fracture of the L2 vertebral body. T1 gadolinium enhanced sagittal magnetic resonance image (B) showed enhancement at the L2 vertebral body and posterior paraspinal muscle layers, revealing a wedge compression fracture of L2. Bone scan (C) showed increased uptake at the L2 vertebral body and the left 10th, 11th, and 12th ribs.

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  FIGURE 5 X-ray (A) of the thoracic spine, raising the suspicion of a compression fracture of the T8 vertebral body (white arrow). Sagittal computed tomography images (B) also hinted at a compression fracture of the T8 vertebral body (white arrow). T1 sagittal magnetic resonance image (C) showed low signal intensity at the upper portion of the T8 vertebral body and revealed a wedge compression fracture on the anterior upper portion of the T8 vertebral body (white arrow).

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  FIGURE 6 Schematic painting of the vertical force and the force of action and reaction. The two forces that loaded on the spine of sitting passengers have different directions. GZ: gravity z-axis.

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