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    2. Deutscher Kongress für Orthopädie und Unfallchirurgie 2026 (DKOU 2026)
    3. Impact of back protectors on spinal injuries in Mountain Biking – a retrospective bi-centric analysis
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Deutscher Kongress für Orthopädie und Unfallchirurgie 2026 (DKOU 2026)

Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC), Deutsche Gesellschaft für Unfallchirurgie (DGU), Berufsverband für Orthopädie und Unfallchirurgie (BVOU)
20.-23.10.2026
Berlin

Meeting Abstract

Impact of back protectors on spinal injuries in Mountain Biking – a retrospective bi-centric analysis

Christian Tinner - Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Schweiz
Sofie Schenk - Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Schweiz
Arne Ackermann - Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Schweiz
Philipp Stoerrle - Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Schweiz
Niklas Rutsch - Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
Moritz Deml - Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Schweiz
Dominik Jakob - Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Schweiz
Alexandru Baja - Department of Orthopaedic Surgery and Traumatology, Kantonsspital Graubünden, Chur, Schweiz
Veit Schoenborn - Department of Orthopaedic Surgery and Traumatology, Kantonsspital Graubünden, Chur, Schweiz
Jan Gewiess - Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Schweiz

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Objectives and questions: To determine whether wearing a back protector influences the incidence, anatomical distribution, and severity of spinal injuries in mountain biking (MTB) accidents.

Material and methods: We conducted a retrospective bicentric cohort study using medical emergency records from 2018–2023 complemented by a standardized questionnaire. Eligible participants were ≥16 years old with a documented MTB-related accident and 211 respondents were included. Based on self-reported protector use, riders were assigned to a back-protector or control group. The primary endpoint was the presence of a spinal injury; secondary endpoints included injury number, anatomical location, severity according to the AO Spine Classification, Injury Severity Score (ISS), and accident characteristics. Propensity score matching with replacement was applied to control for age, sex, and self-rated skill level, yielding 214 weighted cases for analysis. Weighted statistical tests and regression models were used to compare outcomes between groups.

Results: A total of 162 spinal injuries occurred among 85 participants. After matching, the cohort had a mean age of 36 ± 11 years and was predominantly male (81%). The prevalence of spinal injury did not differ significantly between riders wearing versus not wearing a back protector. The anatomical distribution was similar across groups, with the thoracic spine most frequently affected (61%). Injury severity differed significantly: B-type injuries occurred more often without a back protector (62% vs. 33%), while A-type compression injuries were more common among protector users (42% vs. 28%) (p = 0.032). ISS tended to be lower in the protector group, though the weighted comparison narrowly missed statistical significance. Accident circumstances, self-reported speed, and behavioral factors did not differ between groups.

Discussion and conclusions: Back protectors did not reduce the overall rate of spinal injuries in MTB accidents but were associated with less severe injury patterns. These findings suggest a potential protective effect on injury severity and highlight the need for prospective studies and MTB-specific protector standards.