Cycling and spinal trauma: A worrying trend in referrals to a national spine centre M.P. Broe * , J.C. Kelly, P.J. Groarke, K. Synnott, S. Morris National Spinal Unit, Department of Trauma & Orthopaedics, Mater Misericordiae University Hospital, Dublin 7, Ireland article info Article history: Received 16 February 2017 Received in revised form 1 July 2017 Accepted 30 July 2017 Available online xxx Keywords: Trauma Spine Spinal cord injury Road traffic accident Cycling abstract Introduction: Cycling has seen a large increase in popularity worldwide over the last number of years. This has been linked to an increase in the number of road traffic accidents involving cyclists. Participation in cycling as part of competitive sport and endurance events has seen particular growth. Aim: To examine patients referred with spinal trauma related to cycling and to assess whether the growing popularity of cycling and particularly competitive cycling is linked to an increase in spinal trauma. Methods: A retrospective analysis was carried out of a prospectively maintained database of referrals to a national referral centre for spinal trauma over a 4-year period (2010e2013). Data were further analysed for years 2012e2013, as there were incomplete data for years 2010e2011. Results: Spinal injuries involving cyclists increased by 200% from 2010 to 2013. In com- parison those involving cars only increased by 29% and motorcycles reduced by 68%. From 2012 to 2013 there were 24 cyclist trauma referrals. The most common level injured was cervical spine (71%). Five patients (20.8%) had neurological deficit with 12.5% complete paralysis ASIA A disability score. The spinal fixation rate was 29.1%, 16.6% were managed with a HALO device. In total, 25% of patients were injured whilst training on a racer style bicycle, including all of the patients with complete spinal cord injury. Conclusion: There has been a significant increase in spinal trauma due to cycling accidents over this four year period. Competitive cycling has been a factor in the most severely injured patients. Increased public awareness campaigns for those participating in cycling for sport may be warranted. © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. Introduction The health benefits of cycling have been widely published. 1e4 The sport has seen a large increase in popularity worldwide, and especially in Ireland in recent years. According to the 2011 Census carried out by the Central Statistics Office (CSO) 95,000 bikes were sold that year versus 91,732 new vehicles. 5 The number of commuters to work in that same census had increased by 9.6% from 2006 to 2011. * Corresponding author. E-mail address: markbroe@rcsi.ie (M.P. Broe). Available online at www.sciencedirect.com ScienceDirect The Surgeon, Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland www.thesurgeon.net the surgeon xxx (2017) 1 e5 Please cite this article in press as: Broe MP, et al., Cycling and spinal trauma: A worrying trend in referrals to a national spine centre, The Surgeon (2017), http://dx.doi.org/10.1016/j.surge.2017.07.004 http://dx.doi.org/10.1016/j.surge.2017.07.004 1479-666X/© 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.