At professionally Integrated, we want to provide you with information that we feel will make you a better doctor and help more patients that are hurt from traumas like car crashes. Here is a study that was done looking at what happens to the cervical spine and the exiting nerve roots as well as two different types of “anti-whiplash” seats. This study shows a few interesting components that may help us understand our patients injures more after a car crash and how many different injuries can occur from a crash. One interesting fact is how “low speed” the impacts were to cause damage. The insurance companies may argue that a “low speed” or “minimal damage” crash could not have caused injury. In this study the impact speed was between 6.83 to 7.08 MPH. These speeds showed damage. The authors also show that degeneration that may have resulted in stenosis increased the risk of injury. This is another reason we must treat everyone as an individual as too many factors are in play in the “real world”. This study was done with the safest head restraints on the market to reduce injury and the head facing forward.
Here is what the authors write. Make sure to put this in your notes and during patient education. : “Chronic radicular symptoms have been documented in whiplash patients, potentially caused by cervical neural tissue compression during an automobile rear crash.”
“While lower cervical spine cord compression during a rear crash is unlikely in those with normal canal diameters, our results demonstrated foraminal kinematics sufficient to compress spinal ganglia and nerve roots.” Even at these speeds, the IVFs can narrow compressing neural tissue.
“Rear automobile crashes may injure cervical neural tissues leading to clinically documented radicular symptoms of muscle weakness and paresthesias of the neck, shoulders, upper back, and arms in whiplash patients . Sensory hypersensitivity and hypoesthesia have been observed in both chronic whiplash and radiculopathy patients, which may indicate similar injury mechanisms.”
“These loads are contrasted by large compressive neck loads of the present model due to straightening of the kyphotic thoracic curvature and upward torso ramping, which likely increased foraminal height and area narrowing.”
Look what happened even before the head hits the head restraint: “The compressive neck loads with WHIPS, as determined in a separate study using inverse dynamics , reached 617.7 N with peak compression occurring prior to contact of the head with the head restraint.”
“The present data demonstrated minimal effects of WHIPS and AHR in reducing potential ganglia and nerve root compression injuries. In those without cervical stenosis, potential ganglion injury exists at C6/7 due to foraminal width narrowing even with the AHR (Fig. 4a). For those with cervical stenosis, the injury risk greatly increases and spreads to include the ganglia at C4/5 through C6/7 with WHIPS or AHR in addition to the C6/7 nerve root with AHR (Fig. 4b). These potential injuries occur due to intervertebral extension during or following contact of the head with the head restraint.”
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