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

Norris, S. H.; Watt, I.

Affiliations

¹Northern General Hospital, Herries Road, Sheffield 55 7AU, England

²Department of Radiodiagnosis, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, England

Abstract

njury of the neck may result when a motor vehicle is run into from behind; such injury is frequently the cause of prolonged disability and litigation. We report a series of 61 patients with these injuries. A classification, based upon the presenting symptoms and physical signs has been evolved. This classification is shown to be a reliable basis for formulating a prognosis. Factors which adversely affect prognosis include the presence of objective neurological signs, stiffness of the neck, muscle spasm, and pre-existing degenerative spondylosis.

Links

DOI: 10.1302/0301-620X.65B5.6643566

PubMed: 6643566

WoS: A1983SJ47000018

Cited Works (3)

Year	Entry
1971	McKenzie JA, Williams JF. The dynamic behaviour of the head and cervical spine during “whiplash”. J Biomech. December 1971;4(6):477-490.
1956	Gotten N. Survey of one hundred cases of whiplash injury after settlement of litigation. JAMA. October 27, 1956;162(9):865-867.
1955	Severy DM, Mathewson JH, Bechtol CO. Controlled automobile rearend collisions, an investigation of related engineering and medical phenomena. Can Serv Med J. November 1955;11(10):727-759.

Cited By (37)

Year	Entry
1985	States JD. Discussion of “Neck injury to car occupants using seat belts” by D. R. Larder, M. K. Twiss and G. M. Mackay In discussion of: In: 29th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 7-9, 1985; Washington, DC.166-168.
1990	Olsson I, Bunketorp O, Carlsson G, Gustafsson C, Planath I, Norin H, Ysander L. An in-depth study of neck injuries in rear end collisions. In: Proceedings of the 1990 International IRCOBI Conference on the Biomechanics of Impact. September 12-14, 1990; Lyon, France.269-278.
1994	Ryan GA, Moore VM, Dolinis J, Taylor GW. Crash severity and neck strain in car occupants. In: Proceedings of the 1994 International IRCOBI Conference on the Biomechanics of Impact. September 21-23, 1994; Lyon, France.97-107.
2002	Jakobsson L, Norin H, Bunketorp O. In-depth study of whiplash associated disorders in frontal impacts: influencing factors and consequences. In: Proceedings of the 2002 International IRCOBI Conference on the Biomechanics of Impact. September 18-20, 2002; Munich, Germany.
2007	Stemper BD, Yoganandan N, Gennarelli TA, Pintar FA. Toward a lower neck rear impact injury criterion: correlation of lower neck loads with spinal kinematics. In: Proceedings of the 2007 International IRCOBI Conference on the Biomechanics of Impact. September 19-21, 2007; Maastricht, The Netherlands.249-260.
1985	Carlsson G, Nilsson S, Nilsson-Ehle A, Norin H, Ysander L, Örtengren R. Neck injuries in rear end car collisions: biomechanical considerations to improve head restraints. In: Proceedings of the 1985 International IRCOBI/AAAM Conference on the Biomechanics of Impact. September 24-26, 1985; Göteborg, Sweden.277-289.
1993	McConnell WE, Howard RP, Guzman HM, Bomar JB, Raddin JH, Benedict JV, Smith HL, Hatsell CP. Analysis of human test subject kinematic responses to low velocity rear end impacts. In: Proceedings of the SAE International Congress & Exposition. March 1-5, 1993; Detroit, MI. Warrendale, PA: Society of Automotive Engineers:21-30. SAE 930889.
2004	Sundararajan S, Prasad P, Demetropoulos CK, Tashman S, Begeman PC, Yang KH, King AI. Effect of head-neck position on cervical facet stretch of post mortem human subjects during low speed rear end impacts. Stapp Car Crash J. 2004;48:331-372. SAE 2004-22-0015.
1990	Hildingsson C, Toolanen G. Outcome after soft-tissue injury of the cervical spine: a prospective study of 93 car-accident victims. Acta Orthop Scand. August 1990;61(4):357-3597.
2001	Bogduk N, Yoganandan N. Biomechanics of the cervical spine, III: minor injuries. Clin Biomech (Bristol, Avon). May 2001;16(4):267-275.
1987	Deans GT, Magalliard JN, Kerr M, Rutherford WH. Neck sprain: a major cause of disability following car accidents. Injury. 1987;18(1):10-12.
1988	Maimaris C, Barnes MR, Allen MJ. “Whiplash injuries” of the neck: a retrospective study. Injury. November 1988;19(6):393-396.
1989	Otremski I, Marsh JL, Wilde BR, McLardy-Smith PD, Newman RJ. Soft tissue cervical spinal injuries in motor vehicle accidents. Injury. November 1989;20(6):349-351.
1991	Watkinson A, Gargan MF, Bannister GC. Prognostic factors in soft tissue injuries of the cervical spine. Injury. July 1991;22(4):307-309.
2005	Stemper BD, Yoganandan N, Pintar FA. Effects of abnormal posture on capsular ligament elongations in a computational model subjected to whiplash loading. J Biomech. June 2005;38(6):1313-1323.
1998	Harder S, Veilleux M, Suissa S. The effect of socio-demographic and crash-related factors on the prognosis of whiplash. J Clin Epidemiol. May 1998;51(5):377-384.
1995	Sturzenegger M, Radanov BP, Di Stefano G. The effect of accident mechanisms and initial findings on the long-term course of whiplash injury. J Neurol. 1995;242(7):443-449.
1996	Schrader H, Obelieniene D, Bovim G, Surkiene D, Mickeviciene D, Miseviciene I, Sand T. Natural evolution of late whiplash syndrome outside the medicolegal context. Lancet. May 4, 1996;347(9010):1207-1211.
1995	Radanov BP, Sturzenegger M, Di Stefano G. Long-term outcome after whiplash injury: a 2-year follow-up considering features of injury mechanism and somatic, radiologic, and psychosocial findings. Medicine. September 1995;74(5):281-297.
1994	Sturzenegger M, DiStefano G, Radanov BP, Schnidrig A. Presenting symptoms and signs after whiplash injury: the influence of accident mechanisms. Neurology. April 1994;44(4):688-693.
1994	Barnsley L, Lord S, Bogduk N. Whiplash injury. Pain. September 1994;58(3):283-307.
1995	Spitzer O Walter, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, Zeiss E. Scientific monograph of the Quebec task force on whiplash-associated disorders: redefining “whiplash” and its management. Spine. 1995;20(suppl 8):2S-73S.
1999	Freeman MD, Croft AC, Rossignol AM, Weaver DS, Reiser M. A review and methodologic critique of the literature refuting whiplash syndrome. Spine. January 1, 1999;24(1):86-96.
2009	Siegmund GP, Winkelstein BA, Ivancic PC, Svensson MY, Vasavada A. The anatomy and biomechanics of acute and chronic whiplash injury. Traffic Inj Prev. 2009;10(2):101-112.
1999	Winkelstein BA. A Mechanical Basis for Whiplash Injury: The Cervical Facet Joint, Spinal Motion Segment, and Combined Loading [PhD thesis]. Duke University; 1999.
2004	Stemper BD. Whiplash Affects Cervical Spine Biomechanics [PhD thesis]. Marquette University; May 2004.
2009	DeRosia JJ. Role of Gender and Size in Biomechanics of Rear Impact Marquette University; May 2009.
2001	Weaver BT. The Analysis of Tissue Response Following a Single Rigid Blunt Impact in an in Vivo Animal Model [Master's thesis]. East Lansing, MI: Michigan State University; 2001.
2004	Mordaka JK. Finite Element Analysis of Whiplash Injury for Women [PhD thesis]. Nottingham, UK: Nottingham Trent University; September 2004.
2019	Fice JB. Neuromechanics of Neck Muscles: Implications for Whiplash Injury [PhD thesis]. Vancouver, BC: University of British Columbia; April 2019.
2010	Quinn KP. Integrating Electrophysiological, Mechanical, and Optical Methods to Define the Mechanisms of Painful Facet Joint Injury [PhD thesis]. Philadelphia, PA: University of Pennsylvania; 2010.
2010	Fice JB. Numerical Modeling of Whiplash Injury [Master's thesis]. University of Waterloo; 2010.
2020	Shen D. Investigation of Whiplash Associated Disorders Using Finite Element Neck Models With Active Musculature in Frontal, Rear and Lateral Impact [Master's thesis]. University of Waterloo; 2020.
2015	Beeman SM. Biomechanical Response of Human Volunteers and Surrogates in a Variety of Loading Regimes [PhD thesis]. Virginia Polytechnic Institute and State University; 2015.
2016	Chen R. Driver Behavior in Car Following: The Implications for Forward Collision Avoidance [PhD thesis]. Virginia Polytechnic Institute and State University; June 1, 2016.
2005	Sundararajan S. Effect of Head-Neck Position on Cervical Facet Stretch of Post Mortem Human Subjects During Low Speed Rear End Impacts [PhD thesis]. Detroit, MI: Wayne State University; 2005.
2006	Ivancic PC. Cervical Spine Injury During Simulated Automobile Collisions [PhD thesis]. Yale University; May 2006.