Neck sprain—a major cause of disability following car accidents

Deans, G. T.; Magalliard, J.N.; Kerr, Malcolm; Rutherford, W. H.

doi:10.1016/0020-1383(87)90375-5

Cited by 154 publications

(54 citation statements)

References 5 publications

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“…All patients had been sitting in a stationary vehicle when it was impacted from the rear. The onset of symptoms is sometimes delayed, 25,26 and therefore all the passengers in each vehicle were included in the study whether or not they complained of significant symptoms at first attendance. There were 38 road-traffic accidents: 27 of them involved one patient, in ten there were two and in one a driver and two passengers.…”

Section: Methodsmentioning

confidence: 99%

The Behavioural Response to Whiplash Injury

Gargan

Bannister

Main³

et al. 1997

The Journal of Bone and Joint Surgery. British volume

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We studied 50 consecutive patients presenting at an accident department after rear-end vehicle collisions and recorded symptoms and psychological test scores within one week of injury, at three months and at two years. The range of neck movement was noted at three months.Within one week of injury, psychological test scores were normal in 82% of the group but became abnormal in 81% of the patients with intrusive or disabling symptoms at over three months (p < 0.001) and remained abnormal in 69% at two years. The clinical outcome after two years could be predicted at three months with 76% accuracy by neck stiffness, 74% by psychological score and 82% by a combination of these variables.The severity of symptoms after a whiplash injury is related both to the physical restriction of neck movement and to psychological disorder. The latter becomes established within three months of the injury.

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Section: Methodsmentioning

confidence: 99%

The Behavioural Response to Whiplash Injury

Gargan

Bannister

Main³

et al. 1997

The Journal of Bone and Joint Surgery. British volume

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“…Widespread attention has been paid to neck sprain because of the enormous increase in the whiplash-associated disorders (WAD) due to car accidents, especially over the last decades [1,6,9,19,34,41]. However, neck sprain is not only caused by car accidents.…”

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confidence: 99%

Neck sprain not arising from car accidents: a retrospective study covering 25 years

Versteegen

Kingma²,

Meijler

et al. 1998

E Spine J

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IntroductionNeck sprain has usually been associated with car accidents. Widespread attention has been paid to neck sprain because of the enormous increase in the whiplash-associated disorders (WAD) due to car accidents, especially over the last decades [1,6,9,19,34,41]. However, neck sprain is not only caused by car accidents.The diagnostic rubric "sprains and strains of the neck" from the International Classification of Diseases (ICD-9 CM) from the World Health Organization is used by the majority of hospital-based trauma registries. Whiplash is a component of this diagnostic rubric and, according to Penning [26], the primary mechanism of whiplash trauma is a hypertranslation of the head. In contrast to the enormous bulk of whiplash literature, as far as we know, only a few studies have focused on neck sprain. Going back to 1970, we retrieved 19 studies from Medline [21] about neck sprain, of which 9 were about neck sprain due to car accidents [3,7,11,13,14,32,38,40,42] and 3 were about neck sprain due to sports injuries [5,18,35]. The remaining seven studies, in which the aetiology is unclear, describe treatment and research methods [4,12,15,20,23,37,39]. Research results from 1970 were based on data from hospital registries in which no distinction was made between inpatients and outpatients. As far as we know there are no studies analysing trends in neck sprain Abstract During the 25-year period 1970-1994, 680 patients were diagnosed with neck sprain due to causes other than car accidents at the Emergency Room of the University Hospital Groningen. The purpose of the present study was to analyse the prevalence, groups at risk and trends in patients with neck sprain. We defined the population as patients diagnosed with neck sprain that was not due to a car accident (NCA). The binominal test was used to obtain measures of statistical significance, ∆ x was used to obtain both the total increase in the number of neck sprain victims over the whole period and the relative contribution of successive 5-year periods. Over the 25-year period a steady increase in the number of patients was observed from 55 in 1970-1974 to 241 in 1990-1994. The highest

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“…Significant factors in this regard include previous whiplash injury, previous neck symptoms or headache, previous psychological problems, occurrence of acute eye symptoms, multiple symptoms, female gender and older age, work disability limited selfconfidence and limited education [13,14,28,39,53,88,90,118,127,142,173,185,187,195,209,212,[248][249][250]257]. The importance of various vehicle-and impact-related factors has also been studied [61,94,113,114,132,133,141,260] Studies of the roles of all these prognostic factors in the development of long-term symptoms in whiplash patients have produced inconsistent results, since several of the factors considered in the above, as well as in other studies and reviews, have not been found to be related to unfavourable prognosis.…”

Section: Other Prognostic Factorsmentioning

confidence: 99%

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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Neck sprain—a major cause of disability following car accidents

Cited by 154 publications

References 5 publications

The Behavioural Response to Whiplash Injury

The Behavioural Response to Whiplash Injury

Neck sprain not arising from car accidents: a retrospective study covering 25 years

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

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