This last reason is based on the belief that the added weight of a helmet might increase torque on the cervical spine. The risk to the cervical spine is addressed in this study. Over the years there have been a variety of studies on helmet use and CSI in motorcycle crashes, with a couple of reports indicating an increased risk of CSI among helmeted riders and most studies finding no protective effect or harmful biomechanical risk to the cervical spine. Co-author Paul S. Page and colleagues hypothesised that helmet use is not associated with an increased risk of CSI during a motorcycle crash and instead may provide some protection to the wearer. The researchers reviewed the charts of 1061 patients who had been injured in motorcycle crashes and treated at a single Level 1 trauma center in Wisconsin between January 1, 2010, and January 1, 2015. Of those patient, 323 (30.4 percent) were wearing helmets at the time of the crash and 738 (69.6 percent) were not. Notably, Wisconsin law does not require all riders to wear a helmet. At least one CSI was sustained by 7.4 percent of the riders wearing a helmet and 15.4 percent of those not wearing one; this difference in percentages is statically significant (p=0.001). Cervical spine fractures occurred more often in patients who were not wearing helmets (10.8 percent compared to 4.6 percent; p=0.001), as did ligament injuries (1.9 percent compared with 0.3 percent; p=0.04); again these differences are statistically significant. There were no significant differences between groups (helmeted vs un-helmeted riders) with respect to other types of cervical spine injuries that were sustained: nerve root injury, cervical strain, or cord contusion. In summary, Page and colleagues showed that helmet use is associated with a significantly reduced likelihood of sustaining a CSI during a motorcycle crash, particularly fractures of the cervical vertebrae. Although the study population is small, the authors believed the results provide additional evidence in support of wearing helmets to prevent severe injury in motorcycle crashes. When asked about the findings, Dr. Nathaniel P.Brooks, co-author, stated, "Our study suggests that wearing a motorcycle helmet is a reasonable way to limit the risk of injury to the cervical spine in a motorcycle crash." - These findings from the study are published in the Journal of Neurosurgery: Spine.