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Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine.
J Neurotrauma. 2005 Nov; 22(11):1294-302.JN

Abstract

In the present study, we compared magnetic resonance imaging (MRI) findings of soft tissue structures in the upper cervical spine between whiplash-associated disorder (WAD) patients and population-based control persons, and examined whether MRI-verified abnormalities in WAD patients were related to accident-related factors hypothesized to be of importance for severity of injury. A total of 92 whiplash patients and 30 control persons, randomly drawn, were included. Information on the accident-related factors (i.e., head position and impact direction) was obtained by a questionnaire that was answered within 1 week after the accident. The MRI examination was performed 2-9 (mean 6) years after the accident. Focus was on MRI abnormalities of the alar and the transverse ligaments, and the tectorial and posterior atlanto-occipital membranes, graded 0-3. For all neck structures, the whiplash patients had more high-grade lesions (grade 2 or 3) than the control persons (Chi-square test, p < 0.055). An abnormal alar ligament was most common (66.3% graded 2 or 3). Whiplash patients who had been sitting with their head/neck turned to one side at the moment of collision more often had high-grade lesions of the alar and transverse ligaments (p < 0.001, p = 0.040, respectively). Severe injuries to the transverse ligament and the posterior atlanto-occipital membrane were more common in front than in rear end collisions (p < 0.001, p = 0.001, respectively). In conclusion, the difference in MRI-verified lesions between WAD patients and control persons, and in particular the association with head position and impact direction at time of accident, indicate that these lesions are caused by the whiplash trauma.

Authors+Show Affiliations

Kaale BR
Firda Medical Centre, Sandane, Norway. kaale@c2i.net
Krakenes J
No affiliation info available
Albrektsen G
No affiliation info available
Wester K
No affiliation info available

MeSH

Accidents, TrafficAdultCervical VertebraeFemaleHeadHead MovementsHumansLigamentsMagnetic Resonance ImagingMaleMiddle AgedNeckPostureTorsion AbnormalityTrauma Severity IndicesWeight-BearingWhiplash Injuries

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16305317

Citation

Kaale, Bertel Rune, et al. "Head Position and Impact Direction in Whiplash Injuries: Associations With MRI-verified Lesions of Ligaments and Membranes in the Upper Cervical Spine." Journal of Neurotrauma, vol. 22, no. 11, 2005, pp. 1294-302.
Kaale BR, Krakenes J, Albrektsen G, et al. Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine. J Neurotrauma. 2005;22(11):1294-302.
Kaale, B. R., Krakenes, J., Albrektsen, G., & Wester, K. (2005). Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine. Journal of Neurotrauma, 22(11), 1294-302.
Kaale BR, et al. Head Position and Impact Direction in Whiplash Injuries: Associations With MRI-verified Lesions of Ligaments and Membranes in the Upper Cervical Spine. J Neurotrauma. 2005;22(11):1294-302. PubMed PMID: 16305317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine. AU - Kaale,Bertel Rune, AU - Krakenes,Jostein, AU - Albrektsen,Grethe, AU - Wester,Knut, PY - 2005/11/25/pubmed PY - 2006/2/16/medline PY - 2005/11/25/entrez SP - 1294 EP - 302 JF - Journal of neurotrauma JO - J Neurotrauma VL - 22 IS - 11 N2 - In the present study, we compared magnetic resonance imaging (MRI) findings of soft tissue structures in the upper cervical spine between whiplash-associated disorder (WAD) patients and population-based control persons, and examined whether MRI-verified abnormalities in WAD patients were related to accident-related factors hypothesized to be of importance for severity of injury. A total of 92 whiplash patients and 30 control persons, randomly drawn, were included. Information on the accident-related factors (i.e., head position and impact direction) was obtained by a questionnaire that was answered within 1 week after the accident. The MRI examination was performed 2-9 (mean 6) years after the accident. Focus was on MRI abnormalities of the alar and the transverse ligaments, and the tectorial and posterior atlanto-occipital membranes, graded 0-3. For all neck structures, the whiplash patients had more high-grade lesions (grade 2 or 3) than the control persons (Chi-square test, p < 0.055). An abnormal alar ligament was most common (66.3% graded 2 or 3). Whiplash patients who had been sitting with their head/neck turned to one side at the moment of collision more often had high-grade lesions of the alar and transverse ligaments (p < 0.001, p = 0.040, respectively). Severe injuries to the transverse ligament and the posterior atlanto-occipital membrane were more common in front than in rear end collisions (p < 0.001, p = 0.001, respectively). In conclusion, the difference in MRI-verified lesions between WAD patients and control persons, and in particular the association with head position and impact direction at time of accident, indicate that these lesions are caused by the whiplash trauma. SN - 0897-7151 UR - https://www.unboundmedicine.com/medline/citation/16305317/Head_position_and_impact_direction_in_whiplash_injuries:_associations_with_MRI_verified_lesions_of_ligaments_and_membranes_in_the_upper_cervical_spine_ DB - PRIME DP - Unbound Medicine ER -