European Spine Society —The AcroMed prize for spinal research 1997

Abstract

A study was conducted to find out whether in a rear-impact motor vehicle accident, velocity changes in the impact vehicle of between 10 and 15 km/h can cause socalled "whiplash injuries". An assessment of the actual injury mechanism of such whiplash injuries and comparison of vehicle rear-end collisions with amusement park bumper car collisions was also carried out. The study was based on experimental biochemical, kinematic, and clinical analysis with volunteers. In Europe between DM 10 and 20 billion each year is paid out by insurance companies alone for whiplash injuries, although various studies show that the biodynamic stresses arising in the case of slight to moderate vehicle damage may not be high enough to cause such injuries. Most of these experimental studies with cadavers, dummies, and some with volunteers were perforemd with velocity changes below 10 km/h. About 65% of the insurance claims, however, take place in cases with velocity changes of up to 15 km/h. Fourteen male volunteers (aged 28-47 years; average 33.2 years) and five female volunteers (aged 26-37 years; average 32.8 years) participated in 17 vehicle rear-end collisions and 3 bumper car collisions. All cars were fitted with normal European bumper systems. Before, 1 day after and 4-5 weeks after each vehicle crash test and in two of the three bumper car crash tests a clinical examination, a computerized motion analysis, and an MRI examination with Gd-DTPA of the cervical spine of the test persons were performed. During each crash test, in which the test persons were completely screened-off visually and acoustically, the muscle tension of various neck muscles was recorded by surface eletromyography (EMG). The kinematic responses of the test persons and the forces occurring were measured by accelerometers. The kinematic analyses were performed with movement markers and a screening frequency of 700 Hz. To record the acceleration effects of the target vehicle and the bullet vehicle, vehicle accident data recorders were installed in both. The contact phase of the vehicle structures and the kinematics of the test persons were also recorded using high-speed cameras. The results showed that the range of velocity change (vehicle collisions) was 8.7-14.2 km/h (average 11.4 km/h) and the range of mean acceleration of the target vehicle was 2.1-3.6 g (average 2.7 g). The range of velocity change (bumper car collisions) was 8.3-10.6 km/h (average 9.9 km/h) and the range of mean acceleration of the target bumper car was 1.8-2.6 g (average 2.2 g). No injury signs were found at the physical examinations, computerized motion analyses, or at the MRI examinations. Only one of 367 the male volunteers suffered a reduction of rotation of the cervical spine to the left of 10 ° for 10 weeks. The kinematic analysis very clearly showed that the whiplash mechanism consists of translation/extension (high energy) of the cervical spine with consecutive flexion (low energy) of the cervical spine: hyperextension of the cervical spine during the vehicle crashes wa...

Is Acceleration a Valid Proxy for Injury Risk in Minimal Damage Traffic Crashes? A Comparative Review of Volunteer, ADL and Real-World Studies

“…Of the remaining 34 studies, one was excluded as the authors reported barrier equivalent velocity (BEV) rather than delta V [ 18 ]. Among the 33 remaining studies there were data from 408 individual crash tests that could be abstracted for description and analysis [ 16 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. The number of unique test subjects could not be determined from the studies, as multiple studies were performed by the same authors who also included themselves as test subjects, and most papers described two or more crash tests per subject (making the likely number of unique subjects in the included studies between 100 and 200).…”

A Comprehensive Review of Low-Speed Rear Impact Volunteer Studies and a Comparison to Real-World Outcomes

“…A complete collection of the available volunteer literature resulted in a dataset of 1984 total volunteer exposures from 51 individual studies. 5 – 10 , 12 , 15 – 18 , 22 – 26 , 28 – 32 , 34 – 41 , 43 , 46 – 54 , 56 – 59 , 61 – 64 , 66 – 68 , 73 On average, each study performed 40 tests with a range from 1 to 484 tests and used 51 subjects with a range of 1 to 65 volunteers per study. Many of the volunteers experienced more than one exposure (Figure 1 ).…”

Neck Symptoms and Associated Clinical Outcomes in Patients Following Concussion

“…Unique to this investigation, identified patients with severe neck symptoms and concussions had a higher incidence of reported motion sickness history and scored higher on concussion indices (CP screen, VOMS, and ImPACT). The concussion indices data may implicate a higher-energy mechanism of injury as is seen in WAD 31. Meanwhile, the association of motion sickness history with severe neck system may implicate a disturbance to the vestibular system that may be best addressed with case-specific interventions including cervicovestibular rehabilitation to promote recovery 7…”