Spinal Cord Canal Narrowing During Whiplash

(A review of the latest studies by Dr. George Cluen) 

The upper cervical spine is exposed to tremendous forces during rear end collision, even when speeds are under 10 miles an hour. Research shows that ligaments can be stretched or torn, the muscles can be strained, and a new study from Yale shows that the nerves and spinal canal may also be at risk.

In this study, the author studied the biomechanics of a cadaver's cervical spine during a simulated whiplash motion. The spine was subjected to three types of tests: A crash of 7 mph with no head restraint, an active head restraint, and a modern whiplash protection system (like that of the Mercedes Benz M class models 2005 and newer.) The cervical canal houses the spinal cord, this area and the foraminal space was computed during each impact while researchers looked for evidence of spinal canal narrowing.

The study found that "Average peak canal and foramen narrowing could not be statistically differentiated" between the three types of tests.

The study concludes:

"While lower cervical spine cord compression during a rear crash is unlikely, our results demonstrated foraminal kinematics sufficient to compress spinal ganglia and nerve roots. Future anti-whiplash systems designed to reduce cervical injury may reduce radicular symptoms in whiplash patients."

Non-Scientist Translation: 

7 mph is enough to compromise the space around the spinal cord and the connecting nerves momentarily, damage can be done.

This study shows that further seat design developments are needed and even with advanced head restraint technology, injury from rear end collisions is still possible.



Ivanic PC. Cervical neural space narrowing during simulated rear crashes with anti-whiplash systems. European Spine Journal 2012; January 24; Epub before print.

PTSD Tied to Chronic Pain After Auto Injury

 (A review of the latest studies from Dr. George Cluen)

Post traumatic stress disorder, although typically conjuring images of soldiers in shell shock, is becoming an increasingly documented concern after auto accidents. Unfortunately, it doesn't take a major car crash to forever alter a patient's psychological health. Research shows that even patients with mild injuries can show signs of PTSD. Now, a new study from the journal of Rheumatology indicates that PTSD is the biggest predictor of poor quality of life after an auto collision.

Prior to adjusting for socio-demographic characteristics, these results showed that 56% of whiplash patients reported non-recovery one year after the accident, compared to 43% of patients with other mild injuries. Whiplash patients were also more likely to report their symptoms negatively impacted their occupation status (31% versus 23%). These differences were not considered significant however after adjusting for socio-demographics such as gender, family, age, and education level.

What did hold true after adjusting for other stress factors, was the effect PTSD has on chronic pain. Patients with PTSD reported a two-fold increase in residual pain 12 months after the accident and a subsequent reduced quality of life.

These findings demonstrate that identifying and treating PTSD in auto injury patients is vital for preventing persistent pain. Finding healthcare providers that are both sensitive to the emotional needs as much as the physical needs is imperative for relief. At Auto & Work Injury Center we strive to educate our patients about approaching healing in way that addresses all three planes of the injury (the physical, emotional and energetic plane) and we offer supportive programs for this.



Reference

Hours M, et al. One Year After Mild Injury: Comparison of Health Status and Quality of Life between Patients with Whiplash Versus Other Injuries. Journal of Rheumatology 2013.10.3899/jrheum.130406