Acceleration injury of the cervical spine by hypertranslation of the head, II:​ effect of hypertranslation of the head on cervical spine motion:​ discussion of literature data

Penning, L.<sup>1</sup>

Affiliations

¹Department of Neuroradiology, University Hospital, Oostersingel 59, NL-9713-EZ Groningen, The Netherlands

Abstract and keywords (English)

This paper starts from the concept that acceleration injury of the cervical spine is caused by hypertranslation of the head with respect to the trunk, and not by hyperflexion or hyperextension. In this second part of the paper literature describing craniovertebral junction damage after acceleration injury is reviewed. (All other types of lesions are left out of consideration.) Fatal craniocervical disruption has been reported in high-energy acceleration experiments in rhesus monkeys. Comparable craniovertebral disruptions occurred in a large proportion of cervical spine injuries caused by fatal traffic accidents and in some patients surviving such accidents. At least part of these dislocations were inflicted by acceleration injury. Taking hypertranslation of the head as the starting point, reconstruction of the mechanism of injury in these craniovertebral disruptions is done. The “classical” mechanisms, based on hyperflexion or hyperextension, are critically reviewed. It is likely that hypertranslation also plays a role in the less severe whip-lash injury, but this is not further elaborated.

Keywords: Acceleration injury; Head translation; Craniovertebral junction

Abstract and keywords (French)

Cet article s'appuie sur un concept selon lequel les lésions du rachis cervical résultant d'un phénomène d'accélération sont provoquées par une translation excessive de la tête par rapport au tronc, et non par hyper-flexion ou hyperextension. Cette partie de l'article est une revue de la littérature concernant les lésions de la jonction crânio-rachidienne qui résultent d'une accélération (aucun autre type de lésion n'est pris en considération). Des ruptures cranio-rachidiennes fatales ont été rapportées au cours d'accélérations expérimentales chez le Singe Macacus Rhésus. De telles ruptures de la jonction crânio-rachidienne sont retrouvées à l'autopsie dans une large proportion de sujets morts au cours d'un accident de la voie publique; on les retrouve également chez quelques patients survivant à de tels accidents. Ces dislocations sont, au moins en partie, la conséquence d'un phénomène d'accélération. En prenant pour base la translation exagérée de la tête, les auteurs présentent une reconstruction schématique du mécanisme lésionnel dans les ruptures crânio-rachidiennes. Les mécanismes “classiques”, basés sur l'hyperflexion ou l'hyperextension, sont analysés et critiqués. Il est probable que l'hypertranslation joue également un rôle dans des lésions moins sévères du rachis cervical, résultant d'un phénomène de “fléau”, mais celà n'est pas détaillé d'avantage.

Keywords: Lésions par décélération; Translation céphalique; Jonction crânio-vertébrale

Links

DOI: 10.1007/BF00302136

PubMed: 20054941

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Cited By (19)

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