Effect of rotated head posture on dynamic vertebral artery elongation during simulated rear impact

Ivancic, Paul C.; Ito, Shigeki; Tominaga, Yoshihiro; Carlson, Erik J.; Rubin, Wolfgang; Panjabi, Manohar M.

doi:10.1016/j.clinbiomech.2005.10.011

Cited by 22 publications

(10 citation statements)

References 23 publications

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“…66–68 Coupled cervical spine extension and axial rotation beyond the physiologic limit has been hypothesized to cause vertebral artery injury. 66 This hypothesis is supported by biomechanical research, 16 which indicates that elongation-induced vertebral artery injury may occur due to non-physiologic coupled neck motions during an automobile collision. Coupled neck motions may occur due to an offset collision configuration and/or a rotated head posture at the time of the collision.…”

Section: Lesionsmentioning

confidence: 83%

The Role of Tissue Damage in Whiplash-Associated Disorders

Curatolo

Bogduk

Ivancic

et al. 2011

Spine

Self Cite

112

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STUDY DESIGN Non-systematic review of cervical spine lesions in whiplash-associated disorders (WAD). OBJECTIVE To describe whiplash injury models in terms of basic and clinical science, to summarize what can and cannot be explained by injury models, and to highlight future research areas to better understand the role of tissue damage in WAD. SUMMARY OF BACKGROUND DATA The frequent lack of detectable tissue damage has raised questions about whether tissue damage is necessary for WAD and what role it plays in the clinical context of WAD. METHODS Non-systematic review. RESULTS Lesions of various tissues have been documented by numerous investigations conducted in animals, cadavers, healthy volunteers and patients. Most lesions are undetected by imaging techniques. For zygapophysial (facet) joints, lesions have been predicted by bioengineering studies and validated through animal studies; for zygapophysial joint pain, a valid diagnostic test and a proven treatment are available. Lesions of dorsal root ganglia, discs, ligaments, muscles and vertebral artery have been documented in biomechanical and autopsy studies, but no valid diagnostic test is available to assess their clinical relevance. The proportion of WAD patients in whom a persistent lesion is the major determinant of ongoing symptoms is unknown. Psychosocial factors, stress reactions and generalized hyperalgesia have also been shown to predict WAD outcomes. CONCLUSION There is evidence supporting a lesion-based model in WAD. Lack of macroscopically identifiable tissue damage does not rule out the presence of painful lesions. The best available evidence concerns zygapophysial joint pain. The clinical relevance of other lesions needs to be addressed by future research.

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Section: Lesionsmentioning

confidence: 83%

The Role of Tissue Damage in Whiplash-Associated Disorders

Curatolo

Bogduk

Ivancic

et al. 2011

Spine

Self Cite

112

View full text Add to dashboard Cite

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“…Three studies were performed using isolated cervical spine preparations to investigate effects of axial head rotation on intervertebral foramen narrowing, elongation of the vertebral arteries, and strain of the ligaments in the atlanto-axial complex [15,19,50]. Those studies reported significantly decreased intervertebral foramen dimensions and increased elongation of the vertebral artery beyond physiologic limits for impacts simulating axial head rotation.…”

Section: Discussionmentioning

confidence: 99%

“…Those results demonstrated a statistically significant trend. Biomechanical studies using whole PMHS cervical spine specimens subjected to simulated rear impacts demonstrated increased risk of ganglion compression and vertebral artery injury when the head was rotated at the time of impact [15,50]. However, injuries to those structures are not likely responsible for the most commonly reported chronic whiplash-related symptoms including posterior neck pain and suboccipital headache.…”

Section: Introductionmentioning

confidence: 97%

Axial head rotation increases facet joint capsular ligament strains in automotive rear impact

Storvik

Stemper

2010

Med Biol Eng Comput

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Axial head rotation prior to low speed automotive rear impacts has been clinically identified to increase morbidity and symptom duration. The present study was conducted to determine the effect of axial head rotation on facet joint capsule strains during simulated rear impacts. The study was conducted using a validated intact head to first thoracic vertebra (T1) computational model. Parametric analysis was used to assess effects of increasing axial head rotation between 0 and 60° and increasing impact severity between 8 and 24 km/h on facet joint capsule strains. Rear impacts were simulated by horizontally accelerating the T1 vertebra. Characteristics of the acceleration pulse were based on the horizontal T1 acceleration pulse from a series of simulated rear impact experiments using full-body post mortem human subjects. Joint capsule strain magnitudes were greatest in ipsilateral facet joints for all simulations incorporating axial head rotation (i.e., head rotation to the left caused higher ligament strain at the left facet joint capsule). Strain magnitudes increased by 47-196% in simulations with 60° head rotation compared to forward facing simulations. These findings indicate that axial head rotation prior to rear impact increases the risk of facet joint injury.

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“…Relevant sind zudem Beobachtungen der Kopf-Hals-Anatomie (Kiefergelenk, A. vertebralis) während Auff ahrunfällen, bei denen der Kopf extreme Extensions-und Flexionsstellungen einnimmt. Ivancic et al untersuchten den Eff ekt von Auff ahrunfällen bei Kopf in Neutral-Null-Stellung und bei Kopf in leicht rotierter, gebeugter und gestreckter Position auf die Längenveränderung der A. vertebralis [ 9 ] . Welche Auswirkungen die extremen Kopfstellungen, die durch Auff ahrunfälle ausgelöst werden, auf Bewegungen [ 10 ] oder Fehlstellungen [ 11 ] des Kiefergelenks haben, wurde ebenfalls untersucht.…”

Section: Diskussionunclassified