Faculty Collaboration Database

Whiplash syndrome: kinematic factors influencing pain patterns. Spine (Phila Pa 1976) 2001 Jun 01;26(11):1252-8

Date

06/05/2001

Pubmed ID

11389392

DOI

10.1097/00007632-200106010-00015

Scopus ID

2-s2.0-0035368756 (requires institutional sign-in at Scopus site)   118 Citations

Abstract

STUDY DESIGN: The overall, local, and segmental kinematic responses of intact human cadaver head-neck complexes undergoing an inertia-type rear-end impact were quantified. High-speed, high-resolution digital video data of individual facet joint motions during the event were statistically evaluated.

OBJECTIVES: To deduce the potential for various vertebral column components to be exposed to adverse strains that could result in their participation as pain generators, and to evaluate the abnormal motions that occur during this traumatic event.

SUMMARY OF BACKGROUND DATA: The vertebral column is known to incur a nonphysiologic curvature during the application of an inertial-type rear-end impact. No previous studies, however, have quantified the local component motions (facet joint compression and sliding) that occur as a result of rear-impact loading.

METHODS: Intact human cadaver head-neck complexes underwent inertia-type rear-end impact with predominant moments in the sagittal plane. High-resolution digital video was used to track the motions of individual facet joints during the event. Localized angular motion changes at each vertebral segment were analyzed to quantify the abnormal curvature changes. Facet joint motions were analyzed statistically to obtain differences between anterior and posterior strains.

RESULTS: The spine initially assumed an S-curve, with the upper spinal levels in flexion and the lower spinal levels in extension. The upper C-spine flexion occurred early in the event (approximately 60 ms) during the time the head maintained its static inertia. The lower cervical spine facet joints demonstrated statistically greater compressive motions in the dorsal aspect than in the ventral aspect, whereas the sliding anteroposterior motions were the same.

CONCLUSIONS: The nonphysiologic kinematic responses during a whiplash impact may induce stresses in certain upper cervical neural structures or lower facet joints, resulting in possible compromise sufficient to elicit either neuropathic or nociceptive pain. These dynamic alterations of the upper level (occiput to C2) could impart potentially adverse forces to related neural structures, with subsequent development of a neuropathic pain process. The pinching of the lower facet joints may lead to potential for local tissue injury and nociceptive pain.

Author List

Cusick JF, Pintar FA, Yoganandan N

Authors

Frank A. Pintar PhD Chair, Professor in the Biomedical Engineering department at Medical College of Wisconsin
Narayan Yoganandan PhD Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Biomechanical Phenomena
Cadaver
Humans
Middle Aged
Pain
Spine
Whiplash Injuries