Spinal Injuries in Suicidal Jumpers

Spine (Phila Pa 1976). 2019 Jan 1;44(1):E13-E18. doi: 10.1097/BRS.0000000000002757.

Abstract

Study design: This was a retrospective case series at a single institution.

Objective: The study was performed to investigate the characteristics of spinal injuries in survivors of suicidal jumping.

Summary of background data: Spinal fracture/dislocation is associated with high-energy trauma such as that induced by motor vehicle accidents. Survivors of suicidal jumping sometimes sustain spinal injuries. However, the characteristics of such spinal injuries are unclear.

Methods: We identified 87 survivors of suicidal jumping who sustained spinal injuries from 2007 to 2016 in our institution. We compared the demographic data, radiological findings, neurological status, associated injuries, treatments, and mental health conditions between these 87 survivors and 204 non-suicidal patients with spinal injury.

Results: Suicidal jumpers were predominantly female (67%) and 10 years younger than non-suicidal patients. Mental health problems, mainly schizophrenia and depression, were diagnosed in 77% of suicidal jumpers. Neurological damage from spinal trauma was generally less severe in suicidal jumpers than in non-suicidal patients. Most spinal injuries in suicidal jumpers were located in the thoracic or lumbar spine region (85%). Among comorbid injuries, extremity injuries were highly associated with spine injury in suicidal jumpers. Nearly 70% of suicidal jumpers exhibited extremity injury in contrast to 33% of non-suicidal patients. Approximately, 25% of suicidal jumpers underwent surgical treatment. Surgical treatment was similarly performed on suicidal jumpers and non-suicidal patients regardless of the discrepancy in neurological damage between these two groups.

Conclusion: Spinal injuries in suicidal jumpers differed from spinal injuries in non-suicidal patients with regard to sex, age, mental health condition, injury location, neurologic damage, and associated injuries. Most survivors of suicidal jumping were young female patients with mental health problems. They tended to have thoracic and lumbar spine trauma rather than cervical trauma with less severe neurological deficits and a higher incidence of accompanying limb injury.

Level of evidence: 3.

MeSH terms

  • Adult
  • Female
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / etiology
  • Spinal Fractures / psychology
  • Spinal Fractures / surgery
  • Spinal Injuries / diagnostic imaging*
  • Spinal Injuries / etiology*
  • Spinal Injuries / psychology
  • Suicide* / psychology
  • Suicide, Attempted* / psychology
  • Survivors / psychology
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery
  • Young Adult