Incidence of Traumatic Spinal Injury Following Public Policy Update on Moped Usage in South Carolina.

Abstract

Background: Electric scooters and mopeds have become prevalent modes of transportation for many Americans. On 19 November 2018, South Carolina implemented a law mandating the registration of these vehicles with the South Carolina Department of Motor Vehicles, enabling better regulation of moped and scooter drivers on the roads. This study aims to investigate whether the incidence of vertebral fractures and spinal cord injuries related to moped and scooter accidents decreased after the passage of this 2018 South Carolina law.

Methods: Retrospective data from a cohort of 350 patients, 239 before ("prelaw") and 111 after the law ("postlaw") was implemented, seeking care at a level 1 trauma center for moped or scooter-related spinal injuries between January 2014 and December 2022 were analyzed. Differences in the incidence of vertebral fractures and spinal cord injuries before and after the passage of the South Carolina law were calculated. Vertebral fractures were categorized by location on the spine pre- and postlaw. χ ², Wilcoxon rank sum, and Shapiro-Wilk tests were employed to compare variables between groups.

Results: A total of 60 traumatic vertebral fractures (47 prelaw and 13 postlaw) and 7 spinal cord injuries involved moped accidents. There was no significant difference in the incidence rate of vertebral fractures (19.7% vs 11.7%, P = 0.09) or spinal cord injuries (2.9% vs 0%, P = 0.1) between those injured prelaw and postlaw, although there were significant differences between the groups in age (43.2 vs 47.4, P < 0.01) and incidence of men injured (87.9% vs 95.5%, P = 0.03). Multivariable logistic regression demonstrated suffering a moped-related traumatic injury before the implementation of the 2018 South Carolina law (OR = 2.08, 95% CI: 1.09-4.23, P = 0.03) and an increase in age at the time of injury (OR = 1.03, 95% CI: 1.01-1.05, P = 0.01) were independently associated with an increase in the odds ratio of suffering traumatic vertebral fractures following a moped accident when controlling for multiple confounding factors.

Conclusion: Before the implementation of a 2018 South Carolina law that increased moped regulations, moped drivers had a significantly higher odds ratio for suffering a traumatic vertebral fracture compared with after the implementation of the law when controlling for confounding factors. These findings suggest that public policy surrounding moped use may contribute to a decrease in the overall odds of suffering vertebral fractures resulting from moped use and emphasize the need for continual updates to public policy with public safety in mind. This is not only important from a standpoint of patient safety, but it also helps to decrease the amount of health care resources and dollars used.

Clinical relevance: Implementation of public policy surrounding use of mopeds may decrease overall odds of vertebral fractures, which may decrease subsequent health care resource utilization.

Level of evidence: 3: