“Significant increase” in spinal injuries in Afghanistan not seen in Iraq

Insurgents have responded to the military's use of heavily armed MRAPs with massive IEDs which are easily buried under the unpaved roads of Afghanistan. And while the MRAPs can often protect the troops from the types of blast injuries sustained in Humvees in Iraq, back and spinal injuries have increased significantly. The newer all-terrain MRAPs with improved shock-absorbing seating and more complex harness designs have begun to arrive in theater, and doctors are providing engineers with patient data for further design improvements.

Insurgents are building larger bombs to overcome the MRAP's armor and the V-shaped hull, which carries the force of an explosion away from the center of the vehicle. Photo: Sgt. Jason W. Fudge / Marine Corps.

IEDs, MRAPs boosting spinal injuries
By Gregg Zoroya - USA Today
Thursday Nov 5, 2009

BAGRAM, Afghanistan — Afghan insurgents are using roadside bombs powerful enough to throw the military’s new 14-ton, blast-resistant vehicles into the air, increasing broken back injuries among U.S. troops.

Doctors at the main American military hospital here say more than 100 U.S. troops have suffered crushed or damaged spinal columns from being thrown around inside armored Mine Resistant Ambush Protected (MRAP) vehicles in the past five months.

This “significant increase” in spinal injuries was not seen in the Iraq war, says Air Force Col. Warren Dorlac, director of trauma care for both conflicts. One in five wounded service members evacuated from Afghanistan this summer and early fall suffered a spinal injury, and at least 14 were left paralyzed or with loss of sensation, says Air Force Lt. Col. Dustin Zierold, a surgeon and the hospital’s director of trauma care.

“Whatever the G-force [of the roadside bombs], is it very high and very destructive,” Zierold says.

Medical officials here are concerned about whether seating, harnesses and flooring in MRAPs adequately absorb the force of blasts, Zierold says. He says a doctor in Kandahar is trying to design a seat that would guard against spinal injuries.

More research is needed to improve seating and flooring designs, said Marine Brig. Gen. Michael Brogan, director of the Pentagon’s MRAP program. “In future vehicles, that will be the key to survivability,” he says.

The MRAPs are the military’s chief response to the No. 1 killer of American troops in Iraq and now in Afghanistan — roadside bombs. More than 3,500 of the $1.4 million vehicles are in Afghanistan. Brogan said that insurgents are building larger bombs to overcome the MRAP’s armor and the V-shaped hull, which carries the force of an explosion away from the center of the vehicle.

In Afghanistan, fewer paved roads make it easier for insurgents to bury large explosives that can launch these heavy vehicles several feet into the air, Army commanders and doctors say.

A lighter, all-terrain MRAP version arrived in Afghanistan last month with improved shock-absorbing seating and more complex harnesses designs, Brogan says.

Doctors here are gathering data, matching spinal injuries with vehicle types, position of the occupant, surgical treatment that followed, incidence of paralysis and other factors. They are giving the data to engineers to help improve designs, Zierold says.

Col. Warren Dorlac, quoted in the article, is a former chief of trauma care at Landstuhl hospital and is currently serving in Afghanistan.