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Neck ligament strength is decreased following whiplash trauma.
BMC Musculoskelet Disord. 2006 Dec 21; 7:103.BM

Abstract

BACKGROUND

Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additionally, the present data were compared to previously reported control data. The ligaments included the anterior and posterior longitudinal, capsular, and interspinous and supraspinous ligaments, middle-third disc, and ligamentum flavum.

METHODS

A total of 98 bone-ligament-bone specimens (C2-C3 to C7-T1) were prepared from six cervical spines following 3.5, 5, 6.5, and 8 g rear impacts and pre- and post-impact flexibility testing. The specimens were elongated to failure at a peak rate of 725 (SD 95) mm/s. Failure force, elongation, and energy absorbed, as well as stiffness were determined. The mechanical properties were statistically compared among ligaments, and to the control data (significance level: P < 0.05; trend: P < 0.1). The average physiological ligament elongation was determined using a mathematical model.

RESULTS

For all whiplash-exposed ligaments, the average failure elongation exceeded the average physiological elongation. The highest average failure force of 204.6 N was observed in the ligamentum flavum, significantly greater than in middle-third disc and interspinous and supraspinous ligaments. The highest average failure elongation of 4.9 mm was observed in the interspinous and supraspinous ligaments, significantly greater than in the anterior longitudinal ligament, middle-third disc, and ligamentum flavum. The average energy absorbed ranged from 0.04 J by the middle-third disc to 0.44 J by the capsular ligament. The ligamentum flavum was the stiffest ligament, while the interspinous and supraspinous ligaments were most flexible. The whiplash-exposed ligaments had significantly lower (P = 0.036) failure force, 149.4 vs. 186.0 N, and a trend (P = 0.078) towards less energy absorption capacity, 308.6 vs. 397.0 J, as compared to the control data.

CONCLUSION

The present decreases in neck ligament strength due to whiplash provide support for the ligament-injury hypothesis of whiplash syndrome.

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Authors+Show Affiliations

Tominaga Y
Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.
Ndu AB
No affiliation info available
Coe MP
No affiliation info available
Valenson AJ
No affiliation info available
Ivancic PC
No affiliation info available
Ito S
No affiliation info available
Rubin W
No affiliation info available
Panjabi MM
No affiliation info available

MeSH

AgedAged, 80 and overCervical VertebraeFemaleHumansIntervertebral DiscLigamentsLigamentum FlavumLongitudinal LigamentsMaleMiddle AgedNeck PainRange of Motion, ArticularReference ValuesTensile StrengthWeight-BearingWhiplash InjuriesZygapophyseal Joint

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17184536

Citation

Tominaga, Yasuhiro, et al. "Neck Ligament Strength Is Decreased Following Whiplash Trauma." BMC Musculoskeletal Disorders, vol. 7, 2006, p. 103.
Tominaga Y, Ndu AB, Coe MP, et al. Neck ligament strength is decreased following whiplash trauma. BMC Musculoskelet Disord. 2006;7:103.
Tominaga, Y., Ndu, A. B., Coe, M. P., Valenson, A. J., Ivancic, P. C., Ito, S., Rubin, W., & Panjabi, M. M. (2006). Neck ligament strength is decreased following whiplash trauma. BMC Musculoskeletal Disorders, 7, 103.
Tominaga Y, et al. Neck Ligament Strength Is Decreased Following Whiplash Trauma. BMC Musculoskelet Disord. 2006 Dec 21;7:103. PubMed PMID: 17184536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neck ligament strength is decreased following whiplash trauma. AU - Tominaga,Yasuhiro, AU - Ndu,Anthony B, AU - Coe,Marcus P, AU - Valenson,Arnold J, AU - Ivancic,Paul C, AU - Ito,Shigeki, AU - Rubin,Wolfgang, AU - Panjabi,Manohar M, Y1 - 2006/12/21/ PY - 2006/04/17/received PY - 2006/12/21/accepted PY - 2006/12/23/pubmed PY - 2007/2/1/medline PY - 2006/12/23/entrez SP - 103 EP - 103 JF - BMC musculoskeletal disorders JO - BMC Musculoskelet Disord VL - 7 N2 - BACKGROUND: Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additionally, the present data were compared to previously reported control data. The ligaments included the anterior and posterior longitudinal, capsular, and interspinous and supraspinous ligaments, middle-third disc, and ligamentum flavum. METHODS: A total of 98 bone-ligament-bone specimens (C2-C3 to C7-T1) were prepared from six cervical spines following 3.5, 5, 6.5, and 8 g rear impacts and pre- and post-impact flexibility testing. The specimens were elongated to failure at a peak rate of 725 (SD 95) mm/s. Failure force, elongation, and energy absorbed, as well as stiffness were determined. The mechanical properties were statistically compared among ligaments, and to the control data (significance level: P < 0.05; trend: P < 0.1). The average physiological ligament elongation was determined using a mathematical model. RESULTS: For all whiplash-exposed ligaments, the average failure elongation exceeded the average physiological elongation. The highest average failure force of 204.6 N was observed in the ligamentum flavum, significantly greater than in middle-third disc and interspinous and supraspinous ligaments. The highest average failure elongation of 4.9 mm was observed in the interspinous and supraspinous ligaments, significantly greater than in the anterior longitudinal ligament, middle-third disc, and ligamentum flavum. The average energy absorbed ranged from 0.04 J by the middle-third disc to 0.44 J by the capsular ligament. The ligamentum flavum was the stiffest ligament, while the interspinous and supraspinous ligaments were most flexible. The whiplash-exposed ligaments had significantly lower (P = 0.036) failure force, 149.4 vs. 186.0 N, and a trend (P = 0.078) towards less energy absorption capacity, 308.6 vs. 397.0 J, as compared to the control data. CONCLUSION: The present decreases in neck ligament strength due to whiplash provide support for the ligament-injury hypothesis of whiplash syndrome. SN - 1471-2474 UR - https://www.unboundmedicine.com/medline/citation/17184536/Neck_ligament_strength_is_decreased_following_whiplash_trauma_ L2 - https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-7-103 DB - PRIME DP - Unbound Medicine ER -