The relation between seat-belt use and neurologic injury was examined
for the 1,352 patients who had spinal injuries as the result of motor
vehicle crashes and were subsequently admitted to the Midwest Regional
Spinal Cord Injury Center at Northwestern University between 1971 and
1993. Intact lesions were observed in 44% of patients (Frankel level
E), complete lesions in 28% (Frankel A), sensory intact lesions in 8%
(Frankel B), motor intact lesions in 5% (Frankel C), and functional mo
tor lesions in 14% (Frankel D). Whereas only 14% of the sample were we
aring seat belts, 60% of the belted and 41% of the unbelted vehicle oc
cupants had intact lesions. The odds of surviving a motor vehicle cras
h with an intact injury were greater for patients who were wearing a l
ap or shoulder belt (odds = 1.57) for women (odds = 0.63) and for pati
ents whose injury occurred more recently (odds = 1.05). The relation b
etween position in the vehicle and extent of injury was strongest for
rear passengers: intact lesions were sustained by 73% of belted and 35
% of unbelted rear passengers, whereas complete lesions were sustained
by 9% of the belted and 21% of the unbelted rear passengers. In concl
usion, seat belts appear to be an effective means of decreasing the ex
tent of neurologic deficit in those sustaining spinal injuries caused
by motor vehicle crashes. The results of this study support injury-pre
vention efforts that emphasize lap-and shoulder-belt use.