The prognosis of neck injuries resulting from rear-end vehicle collisions

Norris, SH; Watt, Ian

doi:10.1302/0301-620x.65b5.6643566

Cited by 306 publications

(140 citation statements)

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“…Our study is comparable with previous whiplash studies concerning age, gender, and type of car accidents [45]. The frequency of residual symptoms in our study is equivalent to that in reports [14,31]. We found no significant differences between the three subgroups depending on severity of symptoms at follow-up and temperament and character.…”

Section: Discussionsupporting

confidence: 90%

Temperament and character: prognostic factors in whiplash patients?

et al. 2004

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Section: Discussionsupporting

confidence: 90%

Temperament and character: prognostic factors in whiplash patients?

et al. 2004

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“…The QTF-cohort study [20] found chronic symptoms in 13%, 6 months after MVA. In an other study [19], 18% of WAD cases still had complaints after 2 years, while yet another study [18] reported a recovery rate at 66% after 18 months. Female gender was a risk factor for injury to the neck in two studies [9,16].…”

Section: Discussionmentioning

confidence: 89%

“…Female gender was a risk factor for injury to the neck in two studies [9,16]. Neck pain, stiffness in the neck and headache have been the most commonly reported complaints associated with whiplash injury, but numbness and arm pain, dysphagia, visual disturbances and dizziness have also been mentioned [1,18]. Berglund et al [3] recently studied prognostic factors for pain and disability after a whiplash injury and could confirm that in particular initial neck pain was a prognostic factor.…”

Section: Discussionmentioning

confidence: 97%

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Neither the WAD-classification nor the Quebec Task Force follow-up regimen seems to be important for the outcome after a whiplash injury. A prospective study on 186 consecutive patients

2008

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A classification of injury and a follow-up schedule were proposed by the Quebec Task Force (QTF) in 1995. No general agreement about the clinical usefulness of the WAD-classification or of the suggested follow-up regimen exists. A series of 186 consecutive cases seen in the emergency room during the acute phase after a whiplash injury was prospectively studied for 1 year. All findings including history and physical findings were recorded using standardized QTF protocols. In one group follow-up visits were done according to the QTF regimen: at 1, 3, 6, 12 weeks and 1 year after the accident; in a control group no visit was scheduled. The outcome variable was neck pain at 1 year after the accident. After 1 year, 18% of the total number of patients had significant neck pain. Risk factors for chronic neck pain at 1 year after whiplash injury were: neck pain before the accident and a high degree of emotional distress at the time of the accident; both factors independently associated with a tenfold increased risk of developing chronic neck pain. Neither the WAD classification nor the QTF follow-up regimen could be linked to a better outcome. In this study the outcome was associated with patient-specific characteristics and not with physical signs of injury, the depth of the initial evaluation or the follow-up regimen.

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“…When considering all whiplash patients, 44% to 66% of patients had symptoms at one year, but only 12% reported daily neck pain and only 9% reported significant health impairment as a result of the whiplash injury [26][27][28]. Others have shown that 90% of patients presenting with neck pain and neurological signs (WAD III) have continued symptoms at one-year following the injury [29]. The severity of symptoms at initial presentation is thought to be prognostic of a poor outcome at 12 months follow-up [26].…”

Section: Discussionmentioning

confidence: 99%

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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The prognosis of neck injuries resulting from rear-end vehicle collisions

Cited by 306 publications

References 4 publications

Temperament and character: prognostic factors in whiplash patients?

Temperament and character: prognostic factors in whiplash patients?

Neither the WAD-classification nor the Quebec Task Force follow-up regimen seems to be important for the outcome after a whiplash injury. A prospective study on 186 consecutive patients

Clinical and Finite Element Analysis of Acute Whiplash

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