Management of Thoracolumbar Spinal Fracture Caused by an Aircraft Accident

INTRODUCTION: Aircraft crashes are infrequent but often associated with high mortality, morbidity, and only a limited number of survivors. These events are classified as high-energy traumas as aircraft typically maintain significant vertical and horizontal speeds at impact. The forces generated can produce a wide range of injuries, from soft tissue damage to fractures, with particular concern for neurological injury. Due to the low number of survivors, few studies in the literature specifically address spinal injury patterns. METHODS: We retrospectively evaluated thoracolumbar spinal injuries sustained in the aircraft accident that occurred in Istanbul on February 5, 2020. A total of 22 patients with thoracolumbar fractures were transferred to 4 different healthcare centers. Data were analyzed for age, sex, fracture level and morphology, neurological status, treatment methods, and radiological imaging findings. RESULTS: There were 47 spinal injuries identified in 22 patients. Multiple-level fractures were observed in 12 patients. Four had neurological deficits (all American Spinal Injury Association Impairment Scale-D). According to the Thoracolumbar Injury Classification and Severity Score system, seven injuries in six patients were unstable and required surgery. Posterior decompression and stabilization were performed in six patients and vertebroplasty in one. Of the remaining patients, 10 were treated with a brace, and 5 were managed conservatively with pain palliation and supportive care. DISCUSSION: Understanding and analyzing the data from this accident is essential for improving passenger and crew safety and may contribute to preventing morbidity and mortality in future aircraft crashes with changes and adjustments to seat and seatbelt design. Harman F, Guvenc Y, Kivrak C, Cekic E, Dalbayrak S, Aydogmus E, Korkmaz E, Sarioglu E. Management of thoracolumbar spinal fracture caused by an aircraft accident. Aerosp Med Hum Perform. 2026; 97(5):333-336.