Whiplash produces an S-shaped curvature of the neck with hyperextension at lower levels

被引:156
作者
Grauer, JN
Panjabi, MM
Cholewicki, J
Nibu, K
Dvorak, J
机构
[1] YALE UNIV,SCH MED,DEPT ORTHOPAED & REHABIL,BIOMECH LAB,NEW HAVEN,CT 06520
[2] YAMAGUCHI UNIV,SCH MED,DEPT ORTHOPAED,YAMAGUCHI,JAPAN
[3] SCHULTHESS KLIN,ZURICH,SWITZERLAND
关键词
cervical spine biomechanics; mechanism of injury; whiplash trauma;
D O I
10.1097/00007632-199711010-00005
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. A bench-top trauma sled was used to apply four intensities of whiplash trauma to human cadaveric cervical spine specimens and to measure resulting intervertebral rotations using high-speed cinematography. Objectives. To determine the cervical spine levels most prone to injury from whiplash trauma and to hypothesize a mechanism for such injury. Summary of Background Data. Whiplash injuries traditionally have been ascribed to hyperextension of the head, but other mechanisms such as hypertranslation also have been suggested. Methods. Six occiput to T1 (or C7) fresh cadaveric human spines were studied. Physiologic flexion and ex tension motions were recorded with an Optotrak motion analysis system by loading up to 1.0 Nm. Specimens then were secured in a trauma sled, and a surrogate head was attached. Flags fixed to the head and individual vertebrae were monitored with high-speed cinematography (500 frames/sec). Data were collected for 12 traumas in four classes defined by the maximum sled acceleration. The trauma classes were 2.5g, 4.5g, 6.5g, and 8.5g. Significance was defined at P < 0.01. Results. In the whiplash traumas, the peak intervertebral rotations of C6-C7 and C7-T1 significantly exceeded the maximum physiologic extension for all trauma classes studied. The maximum extension of these lower levels occurred significantly before full neck extension. In fact, the upper cervical levels were consistently in flexion at the time of maximum lower level extension. Conclusions. In whiplash, the neck forms an S-shaped curvature, with lower level hyperextension and upper level flexion. this was identified as the injury stage for the lower cervical levels. A subsequent C-shaped curvature with extension of the entire cervical spine produced less lower level extension.
引用
收藏
页码:2489 / 2494
页数:6
相关论文
共 27 条
[1]
WHIPLASH INJURY [J].
BARNSLEY, L ;
LORD, S ;
BOGDUK, N .
PAIN, 1994, 58 (03) :283-307
[2]
CROWE HE, 1928, M W ORTH ASS SAN FRA
[3]
RESPONSE OF A HUMAN HEAD NECK UPPER-TORSO REPLICA TO DYNAMIC LOADING .2. ANALYTICAL NUMERICAL-MODEL [J].
DENG, YC ;
GOLDSMITH, W .
JOURNAL OF BIOMECHANICS, 1987, 20 (05) :487-497
[4]
RESPONSE OF A HUMAN HEAD NECK UPPER-TORSO REPLICA TO DYNAMIC LOADING .1. PHYSICAL MODEL [J].
DENG, YC ;
GOLDSMITH, W .
JOURNAL OF BIOMECHANICS, 1987, 20 (05) :471-&
[5]
Ewing C.L., 1975, P 19 STAPP CAR CRASH
[6]
Ewing C.L, 1969, P 13 STAPP CAR CRASH
[7]
Ewing C. L., 1976, P 20 STAPP CAR CRASH
[8]
ACCELERATION INJURIES OF THE CERVICAL SPINE [J].
MACNAB, I .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1964, 46 (08) :1797-1799
[9]
MacNab I, 1982, SPINE
[10]
MACNAB I, 1966, MANITOBA MED REV MAR, P172