Abstract
Purpose
To define “whiplash” radiologically. Material and methods. A full cervical spine radiographic series (including flexion and extension views) was reviewed in 40 patients with clinically proven “whiplash” injuries and compared to the radiographs in 105 normal controls. The level and degree of kinking or kyphosis, subluxation, and the difference in the amount of fanning between spinous processes on flexion and extension films were measured in each patient.
Results
Localized kinking greater than 10° and over 12 mm of fanning, often occurring at the level below the kinking or kyphosis, occurred mainly in the group of whiplash patients (sensitivity 81%, specificity 76%, accuracy 80%).
Conclusions
Localized kinking greater than 10° and fanning greater than 12 mm are useful measurements by which to separate patients with true whiplash injuries from those with minor ligamentous tears. Flexion and extension views are essential to help define whiplash and other ligamentous injuries of the cervical spine.
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References
Clark WM, Gehweiler JA, Laib R. Twelve significant signs of cervical spine trauma. Skeletal Radiol 1979; 3: 201–205.
Vandemark RM. Radiology of the cervical spine in trauma patients: practice pitfalls and recommendations for improving efficiency and communication. AJR 1990; 155: 465–472.
O'Brien JP, Jonsson H Jr, Rauschning W. “Whiplash” injury of the cervical spine. (Abstract) J Bone Joint Surg [Br] 1992; 74: 154.
Monu J, Bohrer SP, Howard G. Some upper cervical spine norms. Spine 1987; 12: 515–519.
Daffner RH, Deeb ZL, Goldberg AL, Kandabarow A, Rothfus WE. The radiologic assessment of post-traumatic vertebral stability. Skeletal Radiol 1990; 19: 103–108.
Green JD, Harle TS, Harris JH. Anterior subluxation of the cervical spine. AJNR 1981; 2: 243–250.
Simon WH. The cervical kink syndrome: does it indicate a serious post-traumatic condition? In: Simon WH, Ehrlich GE. Medicolegal consequences of trauma. New York: Dekker, 1992: 129–151.
Bohrer SP, Chen YM, Sayers DG. Cervical spine flexion patterns. Skeletal Radiol 1990; 19: 521–525.
Daffner R. Imaging of vertebral trauma. Aspen, Maryland, 1988.
Crowe ME. Injuries to the cervical spine. Presented at the meeting of the Western Orthopedic Association, San Francisco, 1928.
Erichsen JE. Concussions of the spine. Nervous shock and other obscure injuries to the nervous system. Clinical and medicolegal aspects. New York: William Wood, 1886; 57.
Porter KM. Neck sprains after car accidents. (Leading article) Br Med J 1988; 298: 973–974.
McNab I, McCullock J. Backache, 2nd edn. Baltimore: Williams and Wilkins, 1990.
Clinton E, Gilula LA, Murphy WA, Gehweiler JA. The widened disk space: a sign of cervical hyperextension injury. Radiology 1981; 141: 639–644.
Hildingsson C, Hietala S-O, Toolanen G. Scintigraphic findings in acute “whiplash” injury of the cervical spine. Injury 1989; 20: 265–266.
Davis SJ, Teresi LM, Bradley WG, Ziemba MA, Bloze AE. Cervical spine hyperextension injuries: MR findings. Radiology 1991; 180: 245–251.
Norris SH, Watt I. The prognosis of neck injuries resulting from rear-end vehicle collisions. J Bone Joint Surg [Br] 1983; 65-B: 608–611.
Miles KA, Finaly D. Is prevertebral soft tissue swelling a useful sign in injury of the cervical spine? Injury 1988; 19: 177–179.
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Griffiths, H.J., Olson, P.N., Everson, L.I. et al. Hyperextension strain or “whiplash” injuries to the cervical spine. Skeletal Radiol. 24, 263–266 (1995). https://doi.org/10.1007/BF00198411
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DOI: https://doi.org/10.1007/BF00198411