Tensile Properties of the Human Muscular and Ligamentous Cervical Spine

Tensile neck injuries are amongst the m ost serious cervical injuries. Recent advancem ents in autom otive safety devices, while enhancing overall safety, have increased the im portance of tensile neck injury. U nfortunately however, neither reliable hum an cervical tensile tolerance d a ta nor tensile structural d a ta is currently available. The purpose of this study is to provide previously unavailable kinetic and tolerance d ata of the ligamentous cervical spine and determ ine the effect of neck muscle on tensile load response and tolerance. Six male hum an cadaver specimens were used. Isolated ligamentous cervical spine tests (Occiput - T l) were used to quantify the significant differences in kinetics due to head end condition and anteroposterior eccentricity of the tensile load. The spine was then separated into m otion segments for tension-extension failure testing. The upper cervical spine tolerance of 2400 ± 270 N (Occiput-C2) was found to be significantly greater than the lower cervical spine tolerance of 1780 ± 230 N (C4-C5 and C6-C7 segments). D ata from these experim ents were used to develop and validate a com putational model of the ligamentous spine. The model predicted the end condition and eccentricity responses w ith an average RMS error 9.0% of full scale for the tensile force-displacement relationship. Cervical muscular geometry d a ta derived from cadaver dissection and MRI imaging were used to incorporate a muscular response to the ligam entous spine model. The cervical m usculature under m axim al stim ulation was found to increase the tolerance of the cervical spine from 1800 N to 4160 N. In addition, the cervical m usculature offered the lower cervical spine greater protection from tensile injury by carrying a larger percentage of the tensile load in the lower spine th an in the upper spine. This resulted in a predicted shift in the site of injury from the lower cervical spine to the upper cervical spine and offers an explanation of the mechanism of upper cervical spine tension injuries observed clinically. The results from this study have lim ited the range of tensile tolerance from 1.1-6.2 kN to 1.8-4.16 kN. More im portantly, this range in the tensile tolerance is now understood and can be attributed to the varying role of the cervical musculature.

Year	Entry
1995	Borchers RE, Gibson LJ, Burchardt H, Hayes WC. Effects of selected thermal variables on the mechanical properties of trabecular bone. Biomaterials. May 1995;16(7):545-551.
1970	Yamada H. Strength of Biological Materials. Evans FG, ed. Baltimore, MD: Williams & Wilkins Company; 1970.
1973	Walker LB Jr, Harris EH, Pontius UR. Mass, volume, center of mass, and mass moment of inertia of head and head and neck of human body. In: Proceedings of the 17th Stapp Car Crash Conference. November 17-19, 1973; Coronado, CA. Warrendale, PA: Society of Automotive Engineers:525-537. SAE 730985.
1993	Kleinberger M. Application of finite element techniques to the study of cervical spine mechanics. In: Proceedings of the 37th Stapp Car Crash Conference. November 7-8, 1993; San Antonio, TX. Warrendale, PA: Society of Automotive Engineers:261-272. SAE 933131.
1979	Nusholtz GS, Melvin JW, Alem NM. Head impact response comparisons of human surrogates. In: Proceedings of the 23rd Stapp Car Crash Conference. October 17-19, 1979; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:499-541. SAE 791020.
1982	Cheng R, Yang KH, Levine RS, King AI, Morgan R. Injuries to the cervical spine caused by a distributed frontal load to the chest. In: Proceedings of the 26th Stapp Car Crash Conference. October 20-21, 1982; Ann Arbor, MI. Warrendale, PA: Society of Automotive Engineers:1-40. SAE 821155.
1971	Portnoy HD, McElhaney JH, Melvin JW, Croissant PD. Mechanism of cervical spine injury in auto accidents. In: 15th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 20-23, 1971; Colorado Springs, CO.55-83.
1996	Nightingale RW, McElhaney JH, Richardson WJ, Best TM, Myers BS. Experimental impact injury to the cervical spine: relating motion of the head and the mechanism of injury. J Bone Joint Surg. March 1996;78A(3):412-421.
1975	Schneider LW, Foust DR, Bowman BM, Snyder RG, Chaffin DB, Abdelnour TA, Baum JK. Biomechanical properties of the human neck in lateral flexion. In: Proceedings of the 19th Stapp Car Crash Conference. November 17-19, 1975; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:455-485. SAE 751156.
1985	Panjabi MM, Krag M, Summers D, Videman T. Biomechanical time-tolerance of fresh cadaveric human spine specimens. J Orthop Res. 1985;3(3):292-300.
1978	White AA III, Panjabi MM. Clinical Biomechanics of the Spine. Philadelphia, PA: J.B. Lippincott Company; 1978.
1997	Winkelstein BA, Myers BS. The biomechanics of cervical spine injury and implications for injury prevention. Med Sci Sports Exer. July 1997;29(suppl 7):S246-S255.
1992	Shea M, Wittenberg RH, Edwards WT, White AA III, Hayes WC. In vitro hyperextension injuries in the human cadaveric cervical spine. J Orthop Res. November 1992;10(6):911-916.
1965	Sedlin ED. A rheologic model for cortical bone: a study of physical properties of human femoral samples. Acta Orthop Scand. 1965;(suppl 83):1-77.
1991	Shea M, Edwards WT, White AA, Hayes WC. Variations of stiffness and strength along the human cervical-spine. J Biomech. 1991;24(2):95-107.
1991	Myers BS, McElhaney JH, Doherty BJ. The viscoelastic responses of the human cervical spine in torsion: experimental limitations of quasi-linear theory, and a method for reducing these effects. J Biomech. 1991;24(9):811-817.
1989	Yoganandan N, Pintar F, Butler J, Reinartz J, Sances A Jr, Larson SJ. Dynamic response of human cervical spine ligaments. Spine. October 1989;14(10):1102-1110.
1988	Huelke DF, Smock WS, Fuller PM, Nichols GR II. Basilar skull fractures produced by facial impacts: case histories and a review of the literature. In: Proceedings of the 32nd Stapp Car Crash Conference. October 17-19, 1988; Atlanta, GA. Warrendale, PA: Society of Automotive Engineers:35-44. SAE 881711.
1995	Myers BS, Van Ee CA, Camacho DLA, Woolley CT, Best TM. On the structural and material properties of mammalian skeletal muscle and its relevance to human cervical impact dynamics. In: Proceedings of the 39th Stapp Car Crash Conference. November 8-10, 1995; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:203-214. SAE 952723.
1987	Bendjellal F, Tarriere C, Gillet D, Mack P, Guillon F. Head and neck responses under high g-level lateral deceleration. In: Proceedings of the 31st Stapp Car Crash Conference. November 9-11, 1987; New Orleans, LA. Warrendale, PA: Society of Automotive Engineers:29-47. SAE 872196.
1991	Dvorak J, Panjabi MM, Novotny JE, Antinnes JA. In vivo flexion/extension of the normal cervical spine. J Orthop Res. November 1991;9(6):828-834.
1986	Woo SL-Y, Orlando CA, Camp JF, Akeson WH. Effects of postmortem storage by freezing on ligament tensile behavior. J Biomech. 1986;19(5):399-404.
1979	Bucholz RW, Burkhead WZ, Graham W, Petty C. Occult cervical spine injuries in fatal traffic accidents. J Trauma. October 1979;19(10):768-771.
1967	Mertz HJ Jr, Patrick LM. Investigation of the kinematics and kinetics of whiplash. In: Proceedings of the 11th Stapp Car Crash Conference. October 10-11, 1967; Anaheim, CA. Warrendale, PA: Society of Automotive Engineers:267-317. SAE 670919.
1994	de Jager M, Sauren A, Thunnissen J, Wismans J. A three-dimensional head-neck model: validation for frontal and lateral impacts. In: Proceedings of the 38th Stapp Car Crash Conference. October 31–November 2, 1994; Fort Lauderdale, FL. Warrendale, PA: Society of Automotive Engineers:93-109. SAE 942211.
1972	Clemens HJ, Burow K. Experimental investigation on injury mechanisms of cervical spine at frontal and rear-front vehicle impacts. In: Proceedings of the 16th Stapp Car Crash Conference. November 8-10, 1972; Detroit, MI. Warrendale, PA: Society of Automotive Engineers:76-104. SAE 720960.
1990	Pintar FA, Sances A Jr, Yoganandan N, Reinartz J, Maiman DJ, Suh JK, Unger G, Cusick JF, Larson SJ. Biodynamics of the total human cadaveric cervical spine. In: Proceedings of the 34th Stapp Car Crash Conference. November 4-7, 1990; Orlando, FL. Warrendale, PA: Society of Automotive Engineers:55-72. SAE 902309.
1986	Brand RA, Pedersen DR, Friederich JA. The sensitivity of muscle force predictions to changes in physiologic cross-sectional area. J Biomech. 1986;19(8):589-596.
1996	Leitschuh PH, Doherty TJ, Taylor DC, Brooks DE, Ryan JB. Effects of postmortem freezing on tensile failure properties of rabbit extensor digitorurn longus muscle tendon complex. J Orthop Res. September 1996;14(5):830-833.
1995	Callaghan JP, McGill SM. Frozen storage increases the ultimate compressive load of porcine vertebrae. J Orthop Res. September 1995;13(5):809-812.
1984	Pelker RR, Friedlaender GE, Markham TC, Panjabi MM, Moen CJ. Effects of freezing and freeze‐drying on the biomechanical properties of rat bone. J Orthop Res. 1984;1(4):405-411.
1994	Dauvilliers F, Bendjellal F, Weiss M, Lavaste F, Tarriére C. Development of a finite element model of the neck. In: Proceedings of the 38th Stapp Car Crash Conference. October 31–November 2, 1994; Fort Lauderdale, FL. Warrendale, PA: Society of Automotive Engineers:77-91. SAE 942210.
1988	Smeathers JE, Joanes DN. Dynamic compressive properties of human lumbar intervertebral joints: a comparison between fresh and thawed specimens. J Biomech. 1988;21(5):425-433.
1980	Nyquist GW, Begman PC, King AI, Mertz HJ. Correlation of field injuries and GM Hybrid III dummy responses for lap-shoulder belt restraint. J Biomech Eng. May 1980;102(2):103-109.
1975	Panjabi MM, White AA III, Johnson RM. Cervical spine mechanics as a function of transection of components. J Biomech. September 1975;8(5):327-336.
1983	McElhaney JH, Paver JG, McCrackin HJ, Maxwell GM. Cervical spine compression responses. In: Proceedings of the 27th Stapp Car Crash Conference. October 17-19, 1983; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:163-177. SAE 831615.
1998	Kamibayashi LK, Richmond FJR. Morphometry of human neck muscles. Spine. June 15, 1998;23(12):1314-1323.
1983	Williams JL, Belytschko TB. A three-dimensional model of the human cervical spine for impact simulation. J Biomech Eng. November 1983;105(4):321-331.
1995	Gottsauner-Wolf F, Grabowski JJ, Chao EYS, An K-N. Effects of freeze/thaw conditioning on the tensile properties and failure mode of bone-muscle-bone units: a biomechanical and histological study in dogs. J Orthop Res. January 1995;13(1):90-95.
1987	Deng Y-C, Goldsmith W. Response of a human head/neck/upper-torso replica to dynamic loading, II: analytical/numerical model. J Biomech. 1987;20(5):487-497.
1994	Matsushita T, Sato TB, Hirabayashi K, Fujimura S, Asazuma T, Takatori T. X-ray study of the human neck motion due to head inertia loading. In: Proceedings of the 38th Stapp Car Crash Conference. October 31–November 2, 1994; Fort Lauderdale, FL. Warrendale, PA: Society of Automotive Engineers:55-64. SAE 942208.
1984	Merrill T, Goldsmith W, Deng YC. Three-dimensional response of a lumped parameter head-neck model due to impact and impulsive loading. J Biomech. 1984;17(2):81-95.
1993	Blacksin MF. Patterns of fracture after air bag deployment. J Trauma. December 1993;35(6):840-843.
1998	Nightingale RW, Winkelstein BA, Van Ee CA, Myers BS. Injury mechanisms in the pediatric cervical spine during out-of-position airbag deployments. In: 42nd Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 5-7, 1998; Charlottesville, VA.153-164.
1982	Liu YK, Krieger KW, Njus G, Ueno K, Connors M, Wakano K, Thies D. Cervical Spine Stiffness and Geometry of the Young Human Male. Wright-Patterson AFB, Ohio: Air Force Aerospace Medical Research Laboratory; November 1982. Report No. AFAMRL-TR-80-138.
1993	Best TM. A Biomechanical Study of Skeletal Muscle Strain Injuries [PhD thesis]. Duke University; 1993.
1993	Huelke DF, Mackay GM, Morris A, Bradford M. A review of cervical fractures and fracture-dislocations without head impacts sustained by restrained occupants. Accid Anal Prev. December 1993;25(6):731-743.
1997	Camacho DL, Nightingale RW, Robinette JJ, Vanguri SK, Coates DJ, Myers BS. Experimental flexibility measurements for the development of a computational head-neck model validated for near-vertex head impact. In: Proceedings of the 41st Stapp Car Crash Conference. November 13-14, 1997; Lake Buena Vista, FL. Warrendale, PA: Society of Automotive Engineers:473-486. SAE 973345.
1990	Yoganandan N, Sances A Jr, Pintar F, Maiman DJ, Reinartz J, Cusick JF, Larson SJ. Injury biomechanics of the human cervical column. Spine. October 1990;15(10):1031-1039.
1987	Wismans J, Philippens M, van Oorschot E, Kallieris D, Mattern R. Comparison of human volunteer and cadaver head-neck response in frontal flexion. In: Proceedings of the 31st Stapp Car Crash Conference. November 9-11, 1987; New Orleans, LA. Warrendale, PA: Society of Automotive Engineers:1-13. SAE 872194.
1971	Mertz HJ, Patrick LM. Strength and response of the human neck. In: Proceedings of the 15th Stapp Car Crash Conference. November 17-19, 1971; Coronado, CA. Warrendale, PA: Society of Automotive Engineers:207-255. SAE 710855.
1996	Yoganandan N, Pintar FA, Maiman DJ, Cusick JF, Sances A Jr, Walsh PR. Human head-neck biomechanics under axial tension. Med Eng Phys. June 1996;18(4):289-294.
1990	White AA III, Panjabi MM. Clinical Biomechanics of the Spine. 2nd ed. Philadelphia, PA: J.B. Lippincott Company; 1990.
1981	Sances A Jr, Myklebust J, Cusick JF, Weber R, Houterman C, Larson SJ, Walsh P, Chilbert M, Prieto T, Zyvoloski M, Ewing C, Thomas D, Saltzberg B. Experimental studies of brain and neck injury. In: Proceedings of the 25th Stapp Car Crash Conference. September 28-30, 1981; San Francisco, CA. Warrendale, PA: Society of Automotive Engineers:149-194. SAE 811032.
1993	Linde F, Sørensen HCF. The effect of different storage methods on the mechanical properties of trabecular bone. J Biomech. 1993;26(10):1249-1252.
1978	Mertz HJ, Hodgson VR, Thomas LM, Nyquist GW. An assessment of compressive neck loads under injury-producing conditions. Phys Sportsmed. December 1978;6(11):95-106.
1989	Zajac FE. Muscle and tendon: properties, models, scaling, and application to biomechanics and motor control. Crit Rev Biomed Eng. 1989;17(4):359-411.

Year

Entry

1995

Borchers RE, Gibson LJ, Burchardt H, Hayes WC. Effects of selected thermal variables on the mechanical properties of trabecular bone. Biomaterials. May 1995;16(7):545-551.

1970

Yamada H. Strength of Biological Materials. Evans FG, ed. Baltimore, MD: Williams & Wilkins Company; 1970.

1973

Walker LB Jr, Harris EH, Pontius UR. Mass, volume, center of mass, and mass moment of inertia of head and head and neck of human body. In: Proceedings of the 17th Stapp Car Crash Conference. November 17-19, 1973; Coronado, CA. Warrendale, PA: Society of Automotive Engineers:525-537. SAE 730985.

1993

Kleinberger M. Application of finite element techniques to the study of cervical spine mechanics. In: Proceedings of the 37th Stapp Car Crash Conference. November 7-8, 1993; San Antonio, TX. Warrendale, PA: Society of Automotive Engineers:261-272. SAE 933131.

1979

Nusholtz GS, Melvin JW, Alem NM. Head impact response comparisons of human surrogates. In: Proceedings of the 23rd Stapp Car Crash Conference. October 17-19, 1979; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:499-541. SAE 791020.

1982

Cheng R, Yang KH, Levine RS, King AI, Morgan R. Injuries to the cervical spine caused by a distributed frontal load to the chest. In: Proceedings of the 26th Stapp Car Crash Conference. October 20-21, 1982; Ann Arbor, MI. Warrendale, PA: Society of Automotive Engineers:1-40. SAE 821155.

1971

Portnoy HD, McElhaney JH, Melvin JW, Croissant PD. Mechanism of cervical spine injury in auto accidents. In: 15th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 20-23, 1971; Colorado Springs, CO.55-83.

1996

Nightingale RW, McElhaney JH, Richardson WJ, Best TM, Myers BS. Experimental impact injury to the cervical spine: relating motion of the head and the mechanism of injury. J Bone Joint Surg. March 1996;78A(3):412-421.

1975

Schneider LW, Foust DR, Bowman BM, Snyder RG, Chaffin DB, Abdelnour TA, Baum JK. Biomechanical properties of the human neck in lateral flexion. In: Proceedings of the 19th Stapp Car Crash Conference. November 17-19, 1975; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:455-485. SAE 751156.

1985

Panjabi MM, Krag M, Summers D, Videman T. Biomechanical time-tolerance of fresh cadaveric human spine specimens. J Orthop Res. 1985;3(3):292-300.

1978

White AA III, Panjabi MM. Clinical Biomechanics of the Spine. Philadelphia, PA: J.B. Lippincott Company; 1978.

1997

Winkelstein BA, Myers BS. The biomechanics of cervical spine injury and implications for injury prevention. Med Sci Sports Exer. July 1997;29(suppl 7):S246-S255.

1992

Shea M, Wittenberg RH, Edwards WT, White AA III, Hayes WC. In vitro hyperextension injuries in the human cadaveric cervical spine. J Orthop Res. November 1992;10(6):911-916.

1965

Sedlin ED. A rheologic model for cortical bone: a study of physical properties of human femoral samples. Acta Orthop Scand. 1965;(suppl 83):1-77.

1991

Shea M, Edwards WT, White AA, Hayes WC. Variations of stiffness and strength along the human cervical-spine. J Biomech. 1991;24(2):95-107.

1991

Myers BS, McElhaney JH, Doherty BJ. The viscoelastic responses of the human cervical spine in torsion: experimental limitations of quasi-linear theory, and a method for reducing these effects. J Biomech. 1991;24(9):811-817.

1989

Yoganandan N, Pintar F, Butler J, Reinartz J, Sances A Jr, Larson SJ. Dynamic response of human cervical spine ligaments. Spine. October 1989;14(10):1102-1110.

1988

Huelke DF, Smock WS, Fuller PM, Nichols GR II. Basilar skull fractures produced by facial impacts: case histories and a review of the literature. In: Proceedings of the 32nd Stapp Car Crash Conference. October 17-19, 1988; Atlanta, GA. Warrendale, PA: Society of Automotive Engineers:35-44. SAE 881711.

1995

Myers BS, Van Ee CA, Camacho DLA, Woolley CT, Best TM. On the structural and material properties of mammalian skeletal muscle and its relevance to human cervical impact dynamics. In: Proceedings of the 39th Stapp Car Crash Conference. November 8-10, 1995; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:203-214. SAE 952723.

1987

Bendjellal F, Tarriere C, Gillet D, Mack P, Guillon F. Head and neck responses under high g-level lateral deceleration. In: Proceedings of the 31st Stapp Car Crash Conference. November 9-11, 1987; New Orleans, LA. Warrendale, PA: Society of Automotive Engineers:29-47. SAE 872196.

1991

Dvorak J, Panjabi MM, Novotny JE, Antinnes JA. In vivo flexion/extension of the normal cervical spine. J Orthop Res. November 1991;9(6):828-834.

1986

Woo SL-Y, Orlando CA, Camp JF, Akeson WH. Effects of postmortem storage by freezing on ligament tensile behavior. J Biomech. 1986;19(5):399-404.

1979

Bucholz RW, Burkhead WZ, Graham W, Petty C. Occult cervical spine injuries in fatal traffic accidents. J Trauma. October 1979;19(10):768-771.

1967

Mertz HJ Jr, Patrick LM. Investigation of the kinematics and kinetics of whiplash. In: Proceedings of the 11th Stapp Car Crash Conference. October 10-11, 1967; Anaheim, CA. Warrendale, PA: Society of Automotive Engineers:267-317. SAE 670919.

1994

de Jager M, Sauren A, Thunnissen J, Wismans J. A three-dimensional head-neck model: validation for frontal and lateral impacts. In: Proceedings of the 38th Stapp Car Crash Conference. October 31–November 2, 1994; Fort Lauderdale, FL. Warrendale, PA: Society of Automotive Engineers:93-109. SAE 942211.

1972

Clemens HJ, Burow K. Experimental investigation on injury mechanisms of cervical spine at frontal and rear-front vehicle impacts. In: Proceedings of the 16th Stapp Car Crash Conference. November 8-10, 1972; Detroit, MI. Warrendale, PA: Society of Automotive Engineers:76-104. SAE 720960.

1990

Pintar FA, Sances A Jr, Yoganandan N, Reinartz J, Maiman DJ, Suh JK, Unger G, Cusick JF, Larson SJ. Biodynamics of the total human cadaveric cervical spine. In: Proceedings of the 34th Stapp Car Crash Conference. November 4-7, 1990; Orlando, FL. Warrendale, PA: Society of Automotive Engineers:55-72. SAE 902309.

1986

Brand RA, Pedersen DR, Friederich JA. The sensitivity of muscle force predictions to changes in physiologic cross-sectional area. J Biomech. 1986;19(8):589-596.

1996

Leitschuh PH, Doherty TJ, Taylor DC, Brooks DE, Ryan JB. Effects of postmortem freezing on tensile failure properties of rabbit extensor digitorurn longus muscle tendon complex. J Orthop Res. September 1996;14(5):830-833.

1995

Callaghan JP, McGill SM. Frozen storage increases the ultimate compressive load of porcine vertebrae. J Orthop Res. September 1995;13(5):809-812.

1984

Pelker RR, Friedlaender GE, Markham TC, Panjabi MM, Moen CJ. Effects of freezing and freeze‐drying on the biomechanical properties of rat bone. J Orthop Res. 1984;1(4):405-411.

1994

Dauvilliers F, Bendjellal F, Weiss M, Lavaste F, Tarriére C. Development of a finite element model of the neck. In: Proceedings of the 38th Stapp Car Crash Conference. October 31–November 2, 1994; Fort Lauderdale, FL. Warrendale, PA: Society of Automotive Engineers:77-91. SAE 942210.

1988

Smeathers JE, Joanes DN. Dynamic compressive properties of human lumbar intervertebral joints: a comparison between fresh and thawed specimens. J Biomech. 1988;21(5):425-433.

1980

Nyquist GW, Begman PC, King AI, Mertz HJ. Correlation of field injuries and GM Hybrid III dummy responses for lap-shoulder belt restraint. J Biomech Eng. May 1980;102(2):103-109.

1975

Panjabi MM, White AA III, Johnson RM. Cervical spine mechanics as a function of transection of components. J Biomech. September 1975;8(5):327-336.

1983

McElhaney JH, Paver JG, McCrackin HJ, Maxwell GM. Cervical spine compression responses. In: Proceedings of the 27th Stapp Car Crash Conference. October 17-19, 1983; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:163-177. SAE 831615.

1998

Kamibayashi LK, Richmond FJR. Morphometry of human neck muscles. Spine. June 15, 1998;23(12):1314-1323.

1983

Williams JL, Belytschko TB. A three-dimensional model of the human cervical spine for impact simulation. J Biomech Eng. November 1983;105(4):321-331.

1995

Gottsauner-Wolf F, Grabowski JJ, Chao EYS, An K-N. Effects of freeze/thaw conditioning on the tensile properties and failure mode of bone-muscle-bone units: a biomechanical and histological study in dogs. J Orthop Res. January 1995;13(1):90-95.

1987

Deng Y-C, Goldsmith W. Response of a human head/neck/upper-torso replica to dynamic loading, II: analytical/numerical model. J Biomech. 1987;20(5):487-497.

1994

Matsushita T, Sato TB, Hirabayashi K, Fujimura S, Asazuma T, Takatori T. X-ray study of the human neck motion due to head inertia loading. In: Proceedings of the 38th Stapp Car Crash Conference. October 31–November 2, 1994; Fort Lauderdale, FL. Warrendale, PA: Society of Automotive Engineers:55-64. SAE 942208.

1984

Merrill T, Goldsmith W, Deng YC. Three-dimensional response of a lumped parameter head-neck model due to impact and impulsive loading. J Biomech. 1984;17(2):81-95.

1993

Blacksin MF. Patterns of fracture after air bag deployment. J Trauma. December 1993;35(6):840-843.

1998

Nightingale RW, Winkelstein BA, Van Ee CA, Myers BS. Injury mechanisms in the pediatric cervical spine during out-of-position airbag deployments. In: 42nd Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 5-7, 1998; Charlottesville, VA.153-164.

1982

Liu YK, Krieger KW, Njus G, Ueno K, Connors M, Wakano K, Thies D. Cervical Spine Stiffness and Geometry of the Young Human Male. Wright-Patterson AFB, Ohio: Air Force Aerospace Medical Research Laboratory; November 1982. Report No. AFAMRL-TR-80-138.

1993

Best TM. A Biomechanical Study of Skeletal Muscle Strain Injuries [PhD thesis]. Duke University; 1993.

1993

Huelke DF, Mackay GM, Morris A, Bradford M. A review of cervical fractures and fracture-dislocations without head impacts sustained by restrained occupants. Accid Anal Prev. December 1993;25(6):731-743.

1997

Camacho DL, Nightingale RW, Robinette JJ, Vanguri SK, Coates DJ, Myers BS. Experimental flexibility measurements for the development of a computational head-neck model validated for near-vertex head impact. In: Proceedings of the 41st Stapp Car Crash Conference. November 13-14, 1997; Lake Buena Vista, FL. Warrendale, PA: Society of Automotive Engineers:473-486. SAE 973345.

1990

Yoganandan N, Sances A Jr, Pintar F, Maiman DJ, Reinartz J, Cusick JF, Larson SJ. Injury biomechanics of the human cervical column. Spine. October 1990;15(10):1031-1039.

1987

Wismans J, Philippens M, van Oorschot E, Kallieris D, Mattern R. Comparison of human volunteer and cadaver head-neck response in frontal flexion. In: Proceedings of the 31st Stapp Car Crash Conference. November 9-11, 1987; New Orleans, LA. Warrendale, PA: Society of Automotive Engineers:1-13. SAE 872194.

1971

Mertz HJ, Patrick LM. Strength and response of the human neck. In: Proceedings of the 15th Stapp Car Crash Conference. November 17-19, 1971; Coronado, CA. Warrendale, PA: Society of Automotive Engineers:207-255. SAE 710855.

1996

Yoganandan N, Pintar FA, Maiman DJ, Cusick JF, Sances A Jr, Walsh PR. Human head-neck biomechanics under axial tension. Med Eng Phys. June 1996;18(4):289-294.

1990

White AA III, Panjabi MM. Clinical Biomechanics of the Spine. 2nd ed. Philadelphia, PA: J.B. Lippincott Company; 1990.

1981

Sances A Jr, Myklebust J, Cusick JF, Weber R, Houterman C, Larson SJ, Walsh P, Chilbert M, Prieto T, Zyvoloski M, Ewing C, Thomas D, Saltzberg B. Experimental studies of brain and neck injury. In: Proceedings of the 25th Stapp Car Crash Conference. September 28-30, 1981; San Francisco, CA. Warrendale, PA: Society of Automotive Engineers:149-194. SAE 811032.

1993

Linde F, Sørensen HCF. The effect of different storage methods on the mechanical properties of trabecular bone. J Biomech. 1993;26(10):1249-1252.

1978

Mertz HJ, Hodgson VR, Thomas LM, Nyquist GW. An assessment of compressive neck loads under injury-producing conditions. Phys Sportsmed. December 1978;6(11):95-106.

1989

Zajac FE. Muscle and tendon: properties, models, scaling, and application to biomechanics and motor control. Crit Rev Biomed Eng. 1989;17(4):359-411.

Year	Entry
2013	Dibb AT, Cutcliffe HC, Luck JF, Cox CA, Myers BS, Bass CR, Nightingale RW, Arbogast KB, Seacrist T. Pediatric head and neck dynamics in frontal impact: analysis of important mechanical factors and proposed neck performance corridors for six and ten year old ATDs. In: Proceedings of the 23rd International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 27-30, 2013; Seoul, South Korea.
2013	Dibb AT, Cox CA, Nightingale RW, Luck JF, Cutcliffe HC, Myers BS, Arbogast KB, Seacrist T, Bass CR. Importance of muscle activations for biofidelic pediatric neck response in computational models. Traffic Inj Prev. November 22, 2013;14(suppl 1):S116-S127.
2011	Dibb AT. Pediatric Head and Neck Dynamic Response: A Computational Study [PhD thesis]. Duke University; 2011.
2021	Romani S. The Development of an Upper Cervical Spine Model for Use in an Omnidirectional Surrogate Neck [Master's thesis]. Vancouver, BC: University of British Columbia; July 2021.

Year

Entry

2013

Dibb AT, Cutcliffe HC, Luck JF, Cox CA, Myers BS, Bass CR, Nightingale RW, Arbogast KB, Seacrist T. Pediatric head and neck dynamics in frontal impact: analysis of important mechanical factors and proposed neck performance corridors for six and ten year old ATDs. In: Proceedings of the 23rd International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 27-30, 2013; Seoul, South Korea.

2013

Dibb AT, Cox CA, Nightingale RW, Luck JF, Cutcliffe HC, Myers BS, Arbogast KB, Seacrist T, Bass CR. Importance of muscle activations for biofidelic pediatric neck response in computational models. Traffic Inj Prev. November 22, 2013;14(suppl 1):S116-S127.

2011

Dibb AT. Pediatric Head and Neck Dynamic Response: A Computational Study [PhD thesis]. Duke University; 2011.

2021

Romani S. The Development of an Upper Cervical Spine Model for Use in an Omnidirectional Surrogate Neck [Master's thesis]. Vancouver, BC: University of British Columbia; July 2021.