The growing use of electric bikes and scooters has caused an increase in brain and spinal injuries among cyclists and pedestrians, according to a new study.
Led by NYU Langone Health researchers, the study found that these injuries now make up nearly 7 percent of trauma patients admitted to a New York City hospital.
Published online April 15 at Neurosurgerya publication of the Congress of Neurological Surgeons, the paper analyzed 914 patients treated for injuries associated with both pedal-powered and powered micromobility devices at NYC Health + Hospitals/Bellevue over five years. The research team found that one-third of the patients suffered traumatic brain injury, more than two-thirds required hospitalization, and about 30 percent needed intensive care. The proportion of trauma cases seen in emergency rooms (whether patients were admitted or not) involving such devices increased from less than 10 percent in 2018 to more than 50 percent by 2023.
The most common cause of injury was a collision with a car or truck, accounting for about half of the cases, the study authors said. Less than a third of riders wore helmets, and this was associated with significantly higher rates of brain and facial injuries. About one in five patients tested positive for alcohol, which was linked to both worse brain injuries and lower helmet use.
Importantly, the 69 pedestrians analyzed in the study, when struck by electric vehicles, suffered brain injuries at nearly twice the rate of the riders, the authors said. Injuries peaked between 6 and 8 p.m., suggesting that heavy dinnertime e-bike delivery traffic may play a role.
Our study shows that micromobility injuries cause severe trauma to the brain and spine requiring neurosurgical care on an unprecedented scale. In a busy urban environment, we see more and more of these injuries first hand. The data suggest proactive solutions—helmet use, safer bike lane design, and enforcement—could prevent many of these injuries and better protect both riders and pedestrians, who in our study often suffered even more severe brain injuries than the riders themselves.
Hannah Weiss, MD, corresponding author, resident in the Department of Neurosurgery at NYU Grossman School of Medicine
For the study, researchers reviewed the records of every patient treated by the trauma team at NYC Health + Hospitals/Bellevue between January 2018 and August 2023 for injuries involving bicycles or scooters. Patients included riders of both electric and pedal bicycles and scooters, as well as pedestrians struck by these devices. The team collected information on helmet use, alcohol levels, type of injury, brain scans, surgeries performed and length of hospital stay.
“Our findings make it clear that urban infrastructure must continue to improve to keep up with the rapid rise of electric bicycles and scooters,” said Paul P. Huang, MD, associate professor in the Department of Neurosurgery at NYU Grossman School of Medicine and chief of neurosurgery at NYC Health + Hospitals/Bellevue. “Future studies should track these injuries in multiple cities and measure whether protected bike lanes, helmet programs, and speed enforcement actually reduce the number of brain and spine surgeries we do.”
Together with Dr. Weiss and Huang, study authors in the Department of Neurosurgery at NYU Langone were Nora Kim, MD, and Cordelia Orillac, MD. Additional authors were Roee Ber, MD, in the department of neurosurgery at Maimonides Medical Center in Brooklyn. Mason Blacker, MD, of the Barrow Neurological Institute at St. Joseph in Phoenix. and Clotilde Balucani, MD, PhD, in the Department of Neurology at Northwell Health in Manhattan.
