Course and prognostic factors of whiplash: A systematic review and meta-analysis ☆

Kamper, Steven J.; Rebbeck, Trudy; Maher, Christopher G.; McAuley, James H.; Sterling, Michele

doi:10.1016/j.pain.2008.02.019

Cited by 284 publications

(287 citation statements)

References 72 publications

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“…These results are consistent with the findings of Kamper et al who reported in their meta-analysis review that most of the pain recovery following whiplash occurs during the first 3 months post injury [25]. However, our results are at variance with others, who report that severe whiplash associated with neurological sequellae (WAD III) is persistent and debilitating.…”

Section: Discussionsupporting

confidence: 93%

Clinical and Finite Element Analysis of Acute Whiplash

Tannoury¹,

Rihn²,

Wilson³

et al. 2011

TOSPINEJ

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Study Design:A prospective 1-year follow-up study of whiplash patients presenting with neurological signs/or symptoms (WADIII), and whiplash patients with neck pain but no neurologic findings (WADI/II). Objective:We hypothesize that WADI/II and WADIII are distinct entities, with regards to clinical presentation, pathoanatomy, and prognosis.Summary of Background Data: symptoms associated with whiplash injury range from mild neck pain (WADI/II), to injuries associated with neurologic sequellae (WADIII). To date, literature considers whiplash associated disorders (WAD) a single clinical and pathologic entity, with different grades of severity (WADI-IV).Methods: Thirty one subjects were divided into a WADIII study group and a WADI/II comparison group. All subjects underwent H&P, radiographic evaluations, and clinical outcome measures (collected at 3, 6, and 12 months). Statistical analysis was performed (Student T-test, Wilcoxon Signed-Rank test) with significance set at p=0.05. A finite element analysis (FEA) technology (SCOSIA©) was used to predict stresses within the neuraxis.Results: At day 0: Better neurologic assessments, functional performances, and higher quality-of-life measurements were noted in WADI/II compared to WADIII. VAS scores were comparable.At 12 months: Both groups reported improvements in neurologic status and disability symptoms. However functional recovery and quality-of-life measures significantly improved in WADIII, and conversely deteriorated in WADI/II along with notable worsening of pain symptoms. Litigation claims were comparable. FEA predicted higher stress within the neuraxis of WADIII, notably in subjects with preexisting stenosis and odontoid retroflexion. Conclusion:WADI/II and WADIII are distinct entities. Musculoskeletal injury precipitates WADI/II pain symptoms while neuronal stretching leads to WADIII neurologic injuries, which are mostly recoverable.

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Section: Discussionsupporting

confidence: 93%

Clinical and Finite Element Analysis of Acute Whiplash

Tannoury¹,

Rihn²,

Wilson³

et al. 2011

TOSPINEJ

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“…Nonetheless, this is the first longitudinal study on agerelated changes in the posterior extensor muscles of the cervical spine in healthy individuals. Recently, more attention has been focused on the posterior extensor muscles of the cervical spine with regard to minimally invasive cervical spinal surgery [19, 29-31, 33, 34] and patients with cervical spinal trauma, such as whiplash injury [7,9,14,18]. The age-related changes in the posterior extensor muscles described in this study can serve as a control for the assessment of changes in the posterior extensor muscles associated with various cervical spinal disorders and with non-surgical and surgical treatments for these disorders.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional area of posterior extensor muscles of the cervical spine in asymptomatic subjects: a 10-year longitudinal magnetic resonance imaging study

et al. 2011

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There has been no prospective study on agerelated changes of the extensor muscles of the cervical spine in healthy subjects. This study was conducted to elucidate any association between the changes in cross-sectional area of the extensor muscles of the cervical spine on MRIs and cervical disc degeneration or the development of clinical symptoms. Sixty-two subjects who underwent MR imaging by a 1.5-Tesla machine between 1993 and 1996 as asymptomatic volunteers in a previous study were recruited again 10 years later for this follow-up study. The mean interval between the studies was 11.0 ± 0.7 years. The cross-sectional areas of the multifidus, semispinalis cervicis, semispinalis capitis, and splenius capitis at C3-C4, C4-C5, and C5-C6 intervertebral levels were measured on T2-weighted axial images using Image J 1.42. The mean cross-sectional areas of the deep extensor muscles were 1,396.8 ± 337.6 mm 2 at the C3-C4 level, 1,514.7 ± 381.0 mm 2 at the C4-C5 level, and 1,542.8 ± 373.5 mm 2 at the C5-C6 level in the previous investigation. The cross-sectional areas were 1,498.7 ± 374.4 mm 2 at the C3-C4 level, 1,569.9 ± 390.9 mm 2 at the C4-C5 level, and 1,599.6 ± 364.3 mm 2 at the 10-year follow-up. An increase in the cross-sectional area of the muscles was more frequently observed in subjects in their tens to thirties in the initial study, while a decrease was more frequently observed in those in their forties and older in the initial study. Disc degeneration was not correlated with a change in extensor muscle volume. Development of shoulder stiffness during follow-up was significantly negatively correlated with a change in the cross-sectional area of the deep extensor muscles.

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“…However, 94% of the chronic WAD group reported that the trauma occurred at least 2 years ago. A systematic review and meta-analysis of prospective cohort studies of subjects with acute whiplash injuries found that pain, disability, and recovery stabilize within the first 3 months after the trauma [25].…”

Section: Discussionmentioning

confidence: 99%

Symptom profile of persons self-reporting whiplash: a Norwegian population-based study (HUNT 2)

2009

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The aetiology of chronic whiplash associated disorder (WAD) is unclear and the condition has been perceived both as a chronic pain disorder, based on the injury to the neck, and as a functional somatic disorder. Based on the hypothesis that chronic WAD should be perceived as a functional somatic syndrome, we compared the symptom profile of persons with chronic WAD with the profile of persons with a functional somatic disorder, and with the profile of persons with an organic pain disorder. A sample of 55,046 persons participating in a Norwegian population-based health study (HUNT 2) was divided into four study groups: chronic WAD, fibromyalgia, rheumatoid arthritis, and controls (none of these disorders). Symptoms were categorized as pain and stiffness, cardiopulmonary and gastrointestinal symptoms, and mental disorders. Odds ratios (ORs) with 95% confidence intervals (CIs) from logistic regression were used to compare the prevalence of symptoms among the groups. The chronic WAD group had a significantly higher prevalence of symptoms from all body parts, across organ systems and also mental symptoms, compared to the control group. The fibromyalgia group had an even higher prevalence of all symptoms, while the rheumatoid arthritis group showed an increase in the prevalence of particularly pain and stiffness symptoms and also a minor increase in the prevalence of other symptoms compared to the control group. We conclude that this study provide evidence in favour of the hypothesis that chronic WAD should be perceived as a functional somatic syndrome. Persons with chronic WAD had a symptom profile more similar to people with a functional somatic disorder than an organic pain disorder, consisting of a wide array of symptoms, not only predominantly pain symptoms.

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Course and prognostic factors of whiplash: A systematic review and meta-analysis ☆

Cited by 284 publications

References 72 publications

Clinical and Finite Element Analysis of Acute Whiplash

Clinical and Finite Element Analysis of Acute Whiplash

Cross-sectional area of posterior extensor muscles of the cervical spine in asymptomatic subjects: a 10-year longitudinal magnetic resonance imaging study

Symptom profile of persons self-reporting whiplash: a Norwegian population-based study (HUNT 2)

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