Injury of the anterior longitudinal ligament during whiplash simulation

Ivancic, Paul C.; Pearson, Adam M.; Panjabi, Manohar M.; Ito, Shigeki

doi:10.1007/s00586-003-0590-3

Cited by 58 publications

(40 citation statements)

References 42 publications

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“…Panjabi et al [193) have shown that both the upper and lower cervical spine can be influenced by extension trauma during rear-impact injury; flexion injury is less likely to occur. Other studies have shown that simulated pronounced whiplash trauma can lead to structural injuries of the anterior longitudinal ligament [109] and facet joint injuries [197]. Grauer et al [80] have also shown that during whiplash trauma the neck assumes an S-shaped curvature, with hyperextension in the lower part of the cervical spine and function in the upper part of the cervical spine.…”

Section: Biomechanicsmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

“…Injuries of the anterior longitudinal ligament have been described in experimental studies in animals and human cadaver specimens [109,156,293]. Ivancic et al [109] recently presented an experimental study in which whiplash trauma was simulated in an experimental model of the cervical spine.…”

Section: Ligamentsmentioning

confidence: 99%

“…Ivancic et al [109] recently presented an experimental study in which whiplash trauma was simulated in an experimental model of the cervical spine. The elongation of the anterior longitudinal ligament was recorded during physiological loading at four different acceleration speeds.…”

Section: Ligamentsmentioning

confidence: 99%

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Whiplash injuries and associated disorders: new insights into an old problem

Rydevik¹,

Szpalski²,

Aebi³

et al. 2008

Eur Spine J

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SummaryThe Medical Task Force of the Swedish Society of Medicine and the Whiplash Commission has come to the following main conclusions:The term ''whiplash'' is so generally accepted that it should continue to be used, but the term ''whiplash trauma'' should only be used to refer to indirect cervical spine trauma. By deleting WAD grades 0 and IV from the classification system introduced in 1995 by the Quebec Task Force (QTF), the diagnosis of whiplash injury will be more exact and more realistically defined, which will reduce the risk of misunderstanding.The reported incidence of whiplash injuries in Sweden varies depending on the particular investigation cited, and ranges between 1.0 and 3.2/1000 per year. Whiplash injuries represent approximately 1/3 of all claims submitted after traffic injuries to insurance companies in Sweden, and give rise to a medical disability rate of 10% or more. Various studies of how the possibility of an insurance claim influences the course of a whiplash injury have produced quite different results, but generally there is no evidence of significant differences in outcome between those who have and have not sought claim.Ligament injuries can rarely be demonstrated acutely after whiplash trauma, and radiologically verified instability later in the course of the injury is also rare. Experimental studies have shown that whiplash trauma can lead to loads on discs and facet joints that might result in injury of these structures, but there is no scientific evidence to verify such injuries in patients with whiplash injury. Certain studies indicate that a dysfunction in the nervous system may exist in a small proportion of patients with whiplash injury.A series of physiological changes occurs in both the peripheral and the central nervous systems after whiplash injury, comprising peripheral as well as central sensitisation. There is no scientific evidence that such physiological changes are specific to the pain associated with whiplash injury; similar changes have been shown to occur in association with various other pain conditions, acute as well as long-term.It is likely that any previous mental ill-health and the patient's current mental state are both important for the clinical development and course of whiplash injury. To minimise the risk of long-term problems among people with acute whiplash injury, concurrently occurring acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD) should be diagnosed and treated. It is also important to diagnose and adequately treat possible sleep disorder, depression, or anxiety among people with whiplash injury.Neck problems in terms of pain and stiffness, either with or without objective clinical findings such as decreased range of motion and tenderness at palpation (WAD grades I and II), are most common. Symptoms usually appear within the first day and up to a few days after whiplash trauma. Headache commonly occurs, along with pain in the shoulders and the thoracic spine. Neurological symptoms are present in approximately 20% of pat...

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Section: Biomechanicsmentioning

confidence: 99%

Section: Biomechanicsmentioning

confidence: 99%

Section: Ligamentsmentioning

confidence: 99%

Section: Ligamentsmentioning

confidence: 99%

See 2 more Smart Citations

Whiplash injuries and associated disorders: new insights into an old problem

Rydevik¹,

Szpalski²,

Aebi³

et al. 2008

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…But the pathogenesis of whiplash complaints is still poorly understood. Injury to longitudinal ligaments [5][6][7], facet joints [7,8], discs [7], spinal cord [9], or muscles [10,11] has been studied as possible sources of chronic pain. However, no detectable findings are significantly different from asymptomatic subjects, and there is no known association between structure damage and symptoms.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging signal changes of alar and transverse ligaments not correlated with whiplash-associated disorders

Shen

2012

Eur Spine J

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Purpose Hypothesis that loss of integrity of the membranes in the craniocervical junction might be the cause of neck pain in patients with whiplash-associated disorders (WADs) has been proposed. In recent years, with development of more detailed magnetic resonance imaging (MRI) techniques, morphologic changes of the ligaments and membranes in the craniocervical junction, especially alar and transverse ligaments have been discussed. A metaanalysis was performed to evaluate the relationship of MRI signal changes of alar and transverse ligaments and WADs. Methods A systematic search of EMBASE, PUBMED, and Cochrane Library and references from eligible articles were conducted. Comparative studies reporting on evaluating the relationship between MRI high-signal changes of alar and transverse ligaments and WADs were regarded eligible. A pooled estimate of effect size was produced. Results Alar ligaments: Six studies (total n = 622) were included. MRI signal changes of alar ligaments did not appear to be related with WADs (P = 0.20, OR = 1.54, 95 % CI = 0.80-2.94). Heterogeneity was present (I 2 = 46 %, P = 0.10), which was eliminated upon sensitivity analysis bringing the OR to 1.27 (95 % CI = 0.87-1.86, I 2 = 0 %). Transverse ligaments: Four studies (total n = 489) were included. MRI signal changes of transverse ligament did not appear to be related with WADs (P = 0.51, OR = 1.44, 95 % CI = 0.49-4.21). Heterogeneity was present (I 2 = 77 %, P = 0.005), which was eliminated upon sensitivity analysis bringing the OR to 0.79 (95 % CI = 0.49-1.28, I 2 = 0 %). Conclusion MRI signal changes of alar and transverse ligaments are not supposed to be caused by whiplash injury, and MRI examination of alar and transverse ligaments should not be used as the routine workup of patients with WADs.

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