Faculty Collaboration Database

Preinjury cervical alignment affecting spinal trauma. J Neurosurg 2002 Jul;97(1 Suppl):57-62

Date

07/18/2002

Pubmed ID

12120652

DOI

10.3171/spi.2002.97.1.0057

Scopus ID

2-s2.0-0036293738 (requires institutional sign-in at Scopus site)   47 Citations

Abstract

OBJECT: The authors tested the hypothesis that initial alignment of the head-neck complex affects cervical spine injury mechanism, trauma rating, injury classification based on stability, and fracture pattern.

METHODS: Thirty intact human cadaveric head-neck complexes were prepared by fixing the thoracic end in polymethylmethacrylate. The cranium was unconstrained. The initial spinal alignment was described in terms of eccentricity, defined as the anteroposterior position of the occipital condyles with respect to the T-1 vertebral body. The specimens were subjected to impact loading delivered using an electrohydraulic testing device. Outcomes after injury were identified using radiography and computerized tomography. The mechanisms of injury were classified according to fracture pattern into compression-extension, compression-flexion, hyperflexion, and vertical compression. Trauma was graded according to the Abbreviated Injury Scale rating system. Based on clinical assessment, injuries were classified as stable or unstable. Injuries were also classified into bone fracture or nonfracture groups. Analysis of variance tests were used to determine the influence of eccentricity on spinal injury outcomes. Eccentricity significantly influenced the mechanism of injury (p < 0.0001), trauma rating (p < 0.005), and fracture (p < 0.0001) classification. Statistically significant differences, however, were not apparent when the classification of injury was based on stability considerations.

CONCLUSIONS: Spinal alignment is a strong determinant of the biomechanics of impact-induced cervical spine injury.

Author List

Maiman DJ, Yoganandan N, Pintar FA

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

Analysis of Variance
Biomechanical Phenomena
Cervical Vertebrae
Female
Humans
Male
Middle Aged
Spinal Fractures
Spinal Injuries
Spine
Tomography, X-Ray Computed
Trauma Severity Indices