Impact of back protectors on spinal injuries in alpine winter sports: a retrospective cohort study.

Purpose This retrospective cohort study investigated whether back protectors reduce the incidence and severity of spinal injuries in alpine winter sports, hypothesizing they may affect the type, location, and severity rather than fully prevent them.Methods We retrospectively identified patients with alpine winter sports-related injuries admitted to our Level-1 trauma center (2017-2023). Patient and accident data were gathered via phone survey and chart review. Injuries were classified using the AO Spine system, and the impact of back protectors was analyzed using univariate and multivariate analysis in R.Results Out of 1160 identified patients, 232 (81 spinal injuries, 151 non-spinal injuries) completed telephone follow-up (mean 52 months post-injury, SD 19.8). The presence of a spinal injury was not significantly associated with back protector use, but spinal injuries in protector users were more frequently treated conservatively, while non-users required operative treatment slightly more frequently (p = 0.13) and presented with neurological deficits (p = 0.008). After adjusting for confounders, there was no significant reduction in ISS scores. Moreover, wearing a back protector did not significantly impact the overall occurrence of polytrauma.Conclusion Back protectors neither prevented spinal injuries nor provided beneficial protection in polytrauma cases among patients presenting to our level I trauma center.