Cervical neural space narrowing during simulated rear crashes with anti-whiplash systems

Abstract

Purpose Chronic radicular symptoms have been documented in whiplash patients, potentially caused by cervical neural tissue compression during an automobile rear crash. Our goals were to determine neural space narrowing of the lower cervical spine during simulated rear crashes with whiplash protection system (WHIPS) and active head restraint (AHR) and to compare these data to those obtained with no head restraint (NHR). We extrapolated our results to determine the potential for cord, ganglion, and nerve root compression. Methods Our model, consisting of a human neck specimen within a BioRID II crash dummy, was subjected to simulated rear crashes in a WHIPS seat (n = 6, peak 12.0 g and DV 11.4 kph) or AHR seat and subsequently with NHR (n = 6, peak 11.0 g and DV 10.2 kph with AHR; peak 11.5 g and DV 10.7 kph with NHR). Cervical canal and foraminal narrowing were computed and average peak values statistically compared (P \ 0.05) between WHIPS, AHR, and NHR. Results Average peak canal and foramen narrowing could not be statistically differentiated between WHIPS, AHR, or NHR. Peak narrowing with WHIPS or AHR was 2.7 mm for canal diameter and 1.6 mm, 2.7 mm, and 5.9 mm 2 for foraminal width, height and area, respectively. Conclusions While lower cervical spine cord compression during a rear crash is unlikely in those with normal canal diameters, our results demonstrated foraminal kinematics sufficient to compress spinal ganglia and nerve roots. Future anti-whiplash systems designed to reduce cervical neural space narrowing may lead to reduced radicular symptoms in whiplash patients.

Can the transverse foramen/vertebral artery ratio of double transverse foramen subjects be a risk for vertebrobasilar transient ischemic attacks?

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Cortical bone facet spacers for cervical spine decompression: effects on intervertebral kinetics and foraminal area

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