Cervical curvature in acute whiplash injuries: prospective comparative study with asymptomatic subjects

Matsumoto, Morio; Fujimura, Yoshikazu; Suzuki, Noriomi; Toyama, Yoshiaki; Shiga, Hayao

doi:10.1016/s0020-1383(98)00184-3

Cited by 67 publications

(44 citation statements)

References 8 publications

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“…With regards to the evaluation by MRI, Boden et al [1] reported that age-related changes of the cervical spine could be detected in at least 90% of healthy males over the age of 50 and 90% of healthy females over the age of 60. Matsumoto et al [21] compared the alignment of the cervical spine in 495 asymptomatic subjects with those in 488 patients with acute whiplash injury. They reported that there was no difference between the asymptomatic and the patient group in terms of the absence of lordosis or presence of local kyphosis.…”

Section: Discussionmentioning

confidence: 99%

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Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers

et al. 2009

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There have been few studies that investigated and clarified the relationships between progression of degenerative changes and sagittal alignment of the cervical spine. The objective of the study was to longitudinally evaluate the relationships among progression of degenerative changes of the cervical spine with age, the development of clinical symptoms and sagittal alignment of the cervical spine in healthy subjects. Out of 497 symptom-free volunteers who underwent MRI and plain radiography of the cervical spine between 1994 and 1996, 113 subjects (45 males and 68 females) who responded to our contacts were enrolled. All subjects underwent another MRI at an average of 11.3 years after the initial study. Their mean age at the time of the initial imaging was 36.6 ± 14.5 years (11-65 years). The items evaluated on MRI were (1) decrease in signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk space narrowing. Each item was evaluated using a numerical grading system. The subjects were divided into four groups according to the age and sagittal alignment of the cervical spine, i.e., subjects under or over the age of 40 years, and subjects with the lordosis or non-lordosis type of sagittal alignment of the cervical spine. -009-1095-5 During the 10-year period, progression of decrease in signal intensity of the disk, posterior disk protrusion, and disk space narrowing were recognized in 64.6, 65.5, and 28.3% of the subjects, respectively. Progression of posterior disk protrusion was significantly more frequent in subjects over 40 years of age with non-lordosis type of sagittal alignment. Logistic regression analysis revealed that stiff shoulder was closely correlated with females (P = 0.001), and that numbness of the upper extremity was closely correlated with age (P = 0.030) and male (P = 0.038). However, no significant correlation between the sagittal alignment of the cervical spine and clinical symptoms was detected. Sagittal alignment of the cervical spine had some impact on the progression of degenerative changes of the cervical spine with aging; however, it had no correlation with the occurrence of future clinical symptoms.123 Eur Spine J (2009) 18:1644-1651 DOI 10.1007/s00586

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Section: Discussionmentioning

confidence: 99%

“…Thus, it appears that the cervical spine generally shows a lordotic curvature. On the other hand, Matsumoto et al [21] reported that subjects younger than 40 years of age presented a non-lordotic cervical curvature more frequently than those over 40 years.…”

Section: Introductionmentioning

confidence: 98%

Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers

et al. 2009

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“…69 Other studies suggested that kyphosis is a normal variant unrelated to trauma and muscle spasm. 48 One study of 40 patients with WAD within 2 days of injury found no patient with ligamentous, muscular, or other soft tissue injury, 9 and another study of 39 patients imaged within 15 days of injury reached the same conclusion. 61 Some authors have implicated the alar ligament as a source of injury in WAD.…”

Section: Forces Acting On the Head And Neck During An Mvamentioning

confidence: 87%

Whiplash: Pathophysiology, diagnosis, treatment, and prognosis

2004

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We have reviewed the literature relevant to pathophysiology, diagnosis, treatment, and prognosis of whiplash-associated disorder (WAD) since 1995 and provided a brief summary of literature pertaining to forces action on the head and neck during a motor vehicle accident. The scope of the current review is confined to the Quebec guidelines for WAD grades 1-3 but excludes grade 4 (neck complaints and fracture or dislocation). After excluding papers without scientific data and single case reports or case series with fewer than 20 patients, articles were reviewed for methodological quality. The diagnosis remains clinical. No imaging, physiological, or psychological study provides specific diagnostic criteria. In the acute period up to 2 weeks, soft collars or rest and work-leave do not shorten the duration of neck pain. Sick leave is reduced by high-dose methylprednisolone given within 8 h of injury, but confirmatory studies examining the cost-benefit relationship are needed. In the first 6 months, active as opposed to passive treatment results in improved outcomes. Specific exercise strategies have not been studied. For those with symptoms lasting more than 6 months, percutaneous radio-frequency neurotomy can provide pain relief for many months in those responding to blind local anesthetic facet blocks. Intra-articular corticosteroids are ineffective. Uncontrolled trials suggest that multimodal rehabilitation programs result in improved overall function. The overall prognosis for recovery has varied considerably across studies. Such variability is likely due to differences in case identification methods and whether outcome is assessed in terms of symptoms or the receipt of financial compensation for injury. The impact on prognosis of both collision- and patient-related factors is also reviewed.

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“…Neck pain can be considered to be an illness seen as a social phenomenon put in a social context constituting a biopsychosocial model (Waddell 2000). Clinical and radiographic examinations seldom show organic lesions to be responsible for the symptoms in neck pain (Boden et al 1990, Matsumoto et al 1998, instead for example psychosocial and cultural factors have been proposed to be contributory factors (Richter et al 2004). Also, alterations in the central nervous system (neural sensitization) have been suggested as an explanation for the persistence of pain (Purves 2005).…”

Section: Generalmentioning

confidence: 99%

“…Unfortunately, radiographs and MRI rarely give sufficient information about the origin of pain in most patients, unless the patient has a specific pathology. Age-related degenerative MRI findings often have no clinical relevance, and these changes are frequent also in pain-free individuals (Boden et al 1990;Matsumoto et al 1998). Furthermore, it is difficult-if not impossible-to distinguish between ageing disks and pathologically degenerated discs causing symptoms.…”

Section: Originmentioning

confidence: 99%