Skip to main content

Advertisement

Log in

An analysis of whiplash injury outcomes in an Irish population: a retrospective fifteen-year study of a spine surgeon’s experience

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Whiplash injuries result from an acceleration-deceleration injury of the cervical spine. The associated symptoms may include neck pain/stiffness; cervicogenic headaches; interscapular pain; upper limb pain, paraesthesia and weakness. Current treatment protocols recommend conservative management of low-grade whiplash.

Aims

To assess changing practices over time in the management of whiplash-associated disorders in the practice of a specialist spine surgeon and to explore the impact of associated litigation on this patient cohort.

Methods and results

The private medical records of a specialist spine surgeon over a 15-year period (1996–2011) were reviewed. Three hundred one consecutive patients were identified: 169 females and 132 males with a mean age of 37 years ± 13. All were referred by primary care with potential soft tissue injury of the cervical spine following a road traffic accident. Fifty-eight percent had associated back pain. An initial conservative approach was adopted in all cases. Subsequently, 4 patients underwent surgical intervention. Ninety-three percent reported chronic neck pain > 6 months after their injury. Age was the only significant predictor of chronic neck pain (adjusted OR 1.29 for every 5-year increase, p = 0.03). All were ultimately involved in litigation. The establishment of the Personal Injuries Board did not influence the litigation duration during the study period.

Conclusion

Whiplash poses a significant societal economic burden in Ireland and was associated with prolonged symptoms including neck pain and upper limb neuropathic symptoms in this cohort. Associated low-back pain was common. Litigation was linked with presentation in all cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Spitzer WO, Skovron ML, Salmi LR et al (1995) Scientific monograph of the Quebec Task Force on whiplash-associated disorders: redefining “whiplash” and its management. Spine 20:1S–73S

    Article  CAS  Google Scholar 

  2. Holm LW, Carroll LJ, Cassidy JD, Skillgate E, Ahlbom A (2008) Expectations for recovery important in the prognosis of whiplash injuries. PLoS Med 5:e105. https://doi.org/10.1371/journal.pmed.0050105

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sterner Y, Gerdle B (2004) Acute and chronic whiplash disorders--a review. J Rehabil Med 36:193–209; quiz 210

    Article  Google Scholar 

  4. Scholten-Peeters GGM, Verhagen AP, Bekkering GE, van der Windt DAWM, Barnsley L, Oostendorp RAB, Hendriks EJM (2003) Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies. Pain 104:303–322

    Article  Google Scholar 

  5. Osti OL, Gun RT, Abraham G, Pratt NL, Eckerwall G, Nakamura H (2005) Potential risk factors for prolonged recovery following whiplash injury. Eur Spine J 14:90–94. https://doi.org/10.1007/s00586-004-0711-7

    Article  PubMed  Google Scholar 

  6. Ferrari R, Russell A, Kelly AJ (2006) Assessing whiplash recovery--the whiplash disability questionnaire. Aust Fam Physician 35:653–654

    PubMed  Google Scholar 

  7. Pinfold M, Niere KR, O’Leary EF, Hoving JL, Green S, Buchbinder R (2004) Validity and internal consistency of a whiplash-specific disability measure. Spine 29:263–268

    Article  Google Scholar 

  8. Personal Injuries Assessment Board. https://www.piab.ie/eng/. Accessed 1 Nov 2018

  9. Personal Injuries Assessment Board (2006) Book of Quantum

  10. Personal Injuries Commission (2018) Second and Final Report of the Personal Injuries Commission

  11. Mulhall KJ, Moloney M, Burke TE, Masterson E (2003) Chronic neck pain following road traffic accidents in an Irish setting and it’s relationship to seat belt use and low back pain. Ir Med J 96:53–54

    CAS  PubMed  Google Scholar 

  12. Lankester BJA, Garneti N, Gargan MF, Bannister GC (2006) Factors predicting outcome after whiplash injury in subjects pursuing litigation. Eur Spine J 15:902–907. https://doi.org/10.1007/s00586-005-0936-0

    Article  CAS  PubMed  Google Scholar 

  13. Gargan MF, Bannister GC (1990) Long-term prognosis of soft-tissue injuries of the neck. J Bone Joint Surg (Br) 72:901–903

    Article  CAS  Google Scholar 

  14. Hildingsson C, Toolanen G (1990) Outcome after soft-tissue injury of the cervical spine. A prospective study of 93 car-accident victims. Acta Orthop Scand 61:357–359

    Article  CAS  Google Scholar 

  15. Wong JJ, Côté P, Ameis A, Varatharajan S, Varatharajan T, Shearer HM, Brison RJ, Sutton D, Randhawa K, Yu H, Southerst D, Goldgrub R, Mior S, Stupar M, Carroll LJ, Taylor-Vaisey A (2016) Are non-steroidal anti-inflammatory drugs effective for the management of neck pain and associated disorders, whiplash-associated disorders, or non-specific low back pain? A systematic review of systematic reviews by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur Spine J 25:34–61. https://doi.org/10.1007/s00586-015-3891-4

    Article  PubMed  Google Scholar 

  16. Southerst D, Nordin MC, Côté P, Shearer HM, Varatharajan S, Yu H, Wong JJ, Sutton DA, Randhawa KA, van der Velde GM, Mior SA, Carroll LJ, Jacobs CL, Taylor-Vaisey AL (2016) Is exercise effective for the management of neck pain and associated disorders or whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J 16:1503–1523. https://doi.org/10.1016/j.spinee.2014.02.014

    Article  PubMed  Google Scholar 

  17. Söderlund A, Olerud C, Lindberg P (2000) Acute whiplash-associated disorders (WAD): the effects of early mobilization and prognostic factors in long-term symptomatology. Clin Rehabil 14:457–467. https://doi.org/10.1191/0269215500cr348oa

    Article  PubMed  Google Scholar 

  18. Crawford JR, Khan RJK, Varley GW (2004) Early management and outcome following soft tissue injuries of the neck—a randomised controlled trial. Injury 35:891–895. https://doi.org/10.1016/j.injury.2004.01.011

    Article  PubMed  Google Scholar 

  19. Bannister G, Amirfeyz R, Kelley S, Gargan M (2009) Whiplash injury. J Bone Joint Surg Br Vol 91-B:845–850. https://doi.org/10.1302/0301-620X.91B7.22639

    Article  Google Scholar 

  20. Sarrami P, Armstrong E, Naylor JM, Harris IA (2017) Factors predicting outcome in whiplash injury: a systematic meta-review of prognostic factors. J Orthop Traumatol 18:9–16. https://doi.org/10.1007/s10195-016-0431-x

    Article  PubMed  Google Scholar 

  21. Walton DM, MacDermid JC, Giorgianni AA et al (2013) Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis. J Orthop Sports Phys Ther 43:31–43. https://doi.org/10.2519/jospt.2013.4507

    Article  PubMed  Google Scholar 

  22. Sterner Y, Toolanen G, Gerdle B, Hildingsson C (2003) The incidence of whiplash trauma and the effects of different factors on recovery. J Spinal Disord Tech 16:195–199

    Article  Google Scholar 

  23. Oka H, Matsudaira K, Fujii T, Okazaki H, Shinkai Y, Tsuji Y, Tanaka S, Kato R (2015) Risk factors for prolonged treatment of whiplash-associated disorders. PLoS One 10:e0132191. https://doi.org/10.1371/journal.pone.0132191

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Côté P, Soklaridis S (2011) Does early management of whiplash-associated disorders assist or impede recovery? Spine 36:S275–S279. https://doi.org/10.1097/BRS.0b013e3182388d32

    Article  PubMed  Google Scholar 

  25. Rydman E, Ponzer S, Brisson R, Ottosson C, Pettersson-Järnbert H (2018) Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation. Eur Spine J 27:1255–1261. https://doi.org/10.1007/s00586-018-5507-2

    Article  PubMed  Google Scholar 

  26. Spearing NM, Connelly LB, Gargett S, Sterling M (2012) Does injury compensation lead to worse health after whiplash? A systematic review. Pain 153:1274–1282. https://doi.org/10.1016/j.pain.2012.03.007

    Article  PubMed  Google Scholar 

  27. Spearing NM, Gyrd-Hansen D, Pobereskin LH, Rowell DS, Connelly LB (2012) Are people who claim compensation “cured by a verdict”? A longitudinal study of health outcomes after whiplash. J Law Med 20:82–92

    PubMed  Google Scholar 

  28. Casey PP, Feyer AM, Cameron ID (2015) Associations with duration of compensation following whiplash sustained in a motor vehicle crash. Injury 46:1848–1855. https://doi.org/10.1016/j.injury.2015.06.018

    Article  PubMed  Google Scholar 

  29. Casey PP, Feyer AM, Cameron ID (2015) Course of recovery for whiplash associated disorders in a compensation setting. Injury 46:2118–2129. https://doi.org/10.1016/j.injury.2015.08.038

    Article  PubMed  Google Scholar 

  30. Söderlund A, Nordgren L, Sterling M, Stålnacke B-M (2018) Exploring patients’ experiences of the whiplash injury-recovery process – a meta-synthesis. J Pain Res Volume 11:1263–1271. https://doi.org/10.2147/JPR.S158807

    Article  Google Scholar 

  31. Pearce JMS (1999) A critical appraisal of the chronic whiplash syndrome. J Neurol Neurosurg Psychiatry 66:273–276. https://doi.org/10.1136/jnnp.66.3.273

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eva McCabe.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McCabe, E., Jadaan, M., Jadaan, D. et al. An analysis of whiplash injury outcomes in an Irish population: a retrospective fifteen-year study of a spine surgeon’s experience. Ir J Med Sci 189, 211–217 (2020). https://doi.org/10.1007/s11845-019-02035-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-019-02035-2

Keywords

Navigation