Increased use of electric bikes and scooters is leading to a sharp rise in brain and spinal injuries among urban riders and pedestrians, a new study has found.
The study, led by researchers at New York University Langone Health, found that these injuries currently account for nearly 7 percent of trauma patients admitted to one New York City hospital.
Published online on April 15th NeurosurgeryThe study, a publication of the Congress of Neurological Surgeons, analyzed 914 patients treated for injuries related to both pedal-powered and powered micromobility devices over a five-year period at New York City Health + Hospitals/Bellevue. The research team found that one-third of patients sustained traumatic brain injuries, more than two-thirds required hospitalization, and about 30% required intensive care. The proportion of trauma cases seen in emergency rooms (whether the patient was admitted or not) that involved such devices increased from less than 10 percent in 2018 to more than 50 percent by 2023.
The most common cause of injury was collisions with cars and trucks, accounting for about half of the cases, the study authors said. Less than a third of riders wore helmets, which was associated with significantly higher rates of brain and facial injuries. Approximately one in five patients tested positive for alcohol, which was associated with both worse brain injury and lower helmet use.
Importantly, the authors said that the 69 pedestrians analyzed in the study suffered brain injuries at almost twice the rate of those in electric vehicles when they collided with electric vehicles. The peak number of injuries occurred between 6pm and 8pm, suggesting that heavy e-bike delivery traffic during dinner time may have been a contributing factor.
Our study shows that micromobility injuries are causing severe brain and spinal trauma requiring neurosurgical treatment on a scale never seen before. In crowded urban areas, we are seeing more of these injuries firsthand. The data points to practical solutions, such as helmet use, safer bike lane design, and enforcement, that could prevent many of these injuries and better protect both riders and pedestrians, who in our study often suffered more severe brain injuries than the riders themselves. ”
Hannah Weiss, MD, Corresponding Author, Neurosurgery Resident, New York University Grossman School of Medicine
For the study, researchers reviewed the records of all patients treated for bicycle- and scooter-related injuries by New York City Health+ Hospitals/Bellevue’s trauma team from January 2018 to August 2023. Patients included riders of e-bikes, pedal bikes and scooters, as well as pedestrians who were struck by these devices. The team collected information such as helmet usage, alcohol levels, type of injury, brain scans, surgeries performed, and length of hospital stay.
“The results of this study demonstrate that we must continue to improve our urban infrastructure to keep pace with the rapid adoption of electric bikes and scooters,” said Paul P. Huang, MD, associate professor of neurosurgery at New York University Grossman School of Medicine and chief of neurosurgery at New York City Health + Hospitals/Bellevue. “Future studies should track these injuries across multiple cities and measure whether protected bike lanes, helmet programs, and speed enforcement actually reduce the number of brain and spine surgeries.”
Along with the doctors. Study authors Weiss and Huang of New York University Langone College of Neurosurgery were Nora Kim, MD, and Cordelia Orilak, MD. Additional authors are Roee Ber, MD, Department of Neurosurgery, Maimonides Medical Center, Brooklyn; Dr. Mason Blacker of St. Joseph’s Hospital Barrow Neurological Institute in Phoenix; Clotilde Balcani, MD, PhD, Department of Neurology, Northwell Health, Manhattan;
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Reference magazines:
Weiss, H. others. (2026). Fast and fragile: Neurosurgical trauma in the era of micromobility. Neurosurgery. DOI: 10.1227/neu.0000000000003995. https://journals.lww.com/neurosurgery/fulltext/2026/05000/the_fast_and_the_fragile__neurosurgical_trauma_in.2.aspx
