For a study, researchers wanted to examine the prevalence of paediatric spine fractures in the United States and associated injuries, mechanisms of injury (MOI), use of safety devices, and mortality rates using a large, nationwide database. Injuries to the spine account for 1% to 2% of all injuries in children. They are, however, linked to a slew of comorbidities and problems. Motor vehicle accidents (MVAs) are the leading cause of the observed increase in incidence. For all vertebral fractures in patients under 18, a retrospective examination of the National Trauma Data Bank was conducted between 2009 and 2014 (analysis in 2019). Those in MVAs with data on protective device use were included in the subanalysis. Patient demographics, MOI, geographic and anatomical location, concomitant musculoskeletal/organ injury, protective device use, hospital length of stay, surgical procedures, and death were all investigated. There were 34,563 patients in all, including 45,430 vertebral fractures. The average age was 15. The majority of fractures (63.1%) occurred in patients aged 15 to 17, the most common MOI was MVA (66.8%), and the most common geographical region was the South (38%). Overall (58.4% vs 41.6%; P< 0.001) and in MVAs (54.4% vs 45.6%; P< 0.001), males experienced more spine fractures than females. Those in MVAs who used seat belts had a lower risk of cranial (29.6% vs 70.4%; odds ratio [OR]=0.85, 95% confidence interval [CI]: 0.82–0.89; P<0.001) and thoracic (30.1% vs 69.9% ; OR = 0.88, 95% CI: 0.84–0.91; P<0.001) organ injury, multi vertebral (30% vs 70% ; OR = 0.78, 95% CI: 0.73–0.83; P<0.001) and concomitant nonvertebral fractures (30.9% vs 69.1%; OR = 0.89, 95% CI:0.73–0.83; P<0.001), and 21% lower odds of mortality (29.3% vs 70.7%; OR=0.79, 95% CI: 0.66–0.94; P=0.009). During MVA, over 70% of drivers were not restrained, with males aged 15 to 17 committing the bulk of seat belt infractions in the South. Over 60% of paediatric spine fractures occur between the ages of 15 and 17, coinciding with legal driving. MVA is the most common cause, and it has a strong link to morbidity and mortality. Almost two-thirds of paediatric spine fractures in MVAs happened when the children were not wearing seatbelts. The absence of seatbelts was linked to a 20% higher risk of death. New driver’s use of protective gear can considerably minimise the morbidity and death associated with MVA.