The role of torsion in cervical spine trauma

Myers, Barry S.<sup>1</sup>; McElhaney, James H.<sup>1</sup>; Doherty, Brian J.<sup>1</sup>; Paver, Jacqueline G.<sup>2</sup>; Gray, Linda<sup>3</sup>

Affiliations

¹Biomedical Engineering Department and Division of Orthopaedic Surgery, Duke University, Durham, North Carolina

²Failure Analysis, Inc., Palo Alto, California

³Department of Radiology, Duke University, Durham, North Carolina

Abstract and keywords

A dynamic servocontrolled torsion machine has been used to characterize cervical injury due to pure rotation of the head. Resultant force moment, torque, and applied rotation have been measured. Torque applied to the base of the skull resulted in injury to the atlantoaxial joint. No evidence of lower cervical injury was observed by computed tomography, magnetic resonance imaging, in situ fluoroscopy, or visual inspection. Torque applied directly to the lower cervical spine induced ligamentous injury and unilateral facet dislocation; however, the torque to injure the lower cervical spine was significantly greater than the torque to injure the atlantoaxial joint. It was concluded that pure rotation of the head does not mediate lower cervical ligamentous injury because of the comparative weakness of the atlantoaxial joint.

Keywords: torsion; lower cervical spine; kinematics; injury

Links

DOI: 10.1097/00007632-199108000-00002

PubMed: 1948370

WoS: A1991GB23200002

History

Accepted: 1990-06-04

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Cited By (14)

Year	Entry
2004	Haug E, Choi H-Y, Robin S, Beaugonin M. Human models for crash and impact simulation. In: Ayache N, ed. Computational Models for the Human Body. Amsterdam, The Netherlands: Elsevier B.V; 2004:231-452. Ciarlet PG, ed. Handbook of Numerical Analysis; vol 12.
2015	Nightingale RW, Myers BS, Yoganandan N. Neck injury biomechanics. In: Yoganandan N, Nahum AM, Melvin JW, eds. Accidental Injury: Biomechanics and Prevention. 3rd ed. New York: Springer; 2015:259-308.
2017	Wang Z, McInnis J, Benfant L, Feng Z, Lee E. THOR 5th percentile female ATD design. In: Proceedings of the 25th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 5-8, 2017; Detroit, MI.
1991	Nightingale RW, Doherty BJ, Myers BS, McElhaney JH, Richardson WJ. The influence of end condition on human cervical spine injury mechanisms. In: Proceedings of the 35th Stapp Car Crash Conference. November 18-20, 1991; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:391-399. SAE 912915.
1999	Winkelstein BA, Nightingale RW, Richardson WJ, Myers BS. Cervical facet joint mechanics: its application to whiplash injury. In: Proceedings of the 43rd Stapp Car Crash Conference. October 25-27, 1999; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:243-252. SAE 99SC15.
2000	Winkelstein B, Myers BS. Experimental and computational characterization of three-dimensional cervical spine flexibility. Stapp Car Crash J. 2000;44:139-158. SAE 2000-01-SC11.
2004	Meyer F, Bourdet N, Deck C, Willinger R, Raul JS. Human neck finite element model development and validation against original experimental data. Stapp Car Crash J. 2004;48:177-206. SAE 2004-22-0008.
1995	Myers BS, Winkelstein BA. Epidemiology, classification, mechanism, and tolerance of human cervical spine injuries. Crit Rev Biomed Eng. 1995;23(5-6):307-409.
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.
2000	Winkelstein BA, Nightingale RW, Richardson WJ, Myers BS. The cervical facet capsule and its role in whiplash injury: a biomechanical investigation. Spine. May 15, 2000;25(10):1238-1246.
2000	Kumaresan S, Yoganandan N, Pintar FA, Mueller WM. Biomechanics of pediatric cervical spine: compression, flexion and extension responses. J Crash Prev Injury Control. 2000;2(2):87-101.
2018	Quarrington RD. Towards Understanding the Injury Mechanics and Clinical Outcomes of Traumatic Subaxial Cervical Facet Dislocation and Fracture-Dislocation [PhD thesis]. University of Adelaide; December 2018.
1999	Winkelstein BA. A Mechanical Basis for Whiplash Injury: The Cervical Facet Joint, Spinal Motion Segment, and Combined Loading [PhD thesis]. Duke University; 1999.
2013	Toomey DE. Cervical Spine Tolerance and Response in Compressive Loading Modes Including Combined Compression and Lateral Bending [PhD thesis]. Detroit, MI: Wayne State University; May 2013.