Cervical spine hyperextension injuries: MR findings.

Abstract

Cervical hyperextension injuries are common and often show minimal radiographic abnormalities, even with severe or unstable lesions. Fourteen patients, nine with acceleration hyperextension "whiplash" injuries and five injured by direct frontal head trauma, underwent magnetic resonance (MR) imaging within 4 months of injury. Five of seven patients with anterior spinal column injuries showed characteristic separation of the disk from the vertebral end plate, lesions still evident as late as 9 months after injury. The demonstration of this type of lesion and its delayed resolution may have prognostic and surgical implications. These lesions, anterior longitudinal ligament injuries, anterior annular tears, and occult anterior vertebral end-plate fractures usually occurred at multiple levels except when preexistent degenerative disk narrowing reduced spine mobility. Seven patients had acute cervical disk herniations causing cord impingement. Radiographically occult injuries are well demonstrated with MR imaging, and findings correspond to previously described surgical and anatomical pathologic conditions.

Temperament and character: prognostic factors in whiplash patients?

“…Our study is comparable with previous whiplash studies concerning age, gender, and type of car accidents [45]. The frequency of residual symptoms in our study is equivalent to that in reports [14,31]. We found no significant differences between the three subgroups depending on severity of symptoms at follow-up and temperament and character.…”

Injury of the anterior longitudinal ligament during whiplash simulation

“…A magnetic resonance imaging study demonstrated injuries to both components in whiplash patients, and similar injuries have also been discovered at surgery and autopsy [4,8,16]. Whiplash simulations using cadavers and monkeys have also produced ALL tears and anterior disc detachments [22,46].…”

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

“…Also, after 1 year it was observed that considerable headache was more frequent in the group with traumatic findings (OR 2.8; 95 CI 0. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] and this group had a higher median headache intensity (Table 6). These above mentioned associations were not significant and the group did not differ otherwise from other participants ( Table 7).…”

“…To explore the biological component of neck pain following whiplash injuries, studies of magnetic resonance imaging (MRI) have been performed in order to visualise potential damage to the cervical spine [3,4,8,17,[21][22][23]29]. Generally, very few identifications of traumatic lesions have been described in the acute phase after whiplash injuries and findings do not seem to be associated with the prognosis [4,17,29].…”

“…It seems that standard MRI is not the answer to finding the aetiology of WAD, but existing results are based upon small trials [3,4,8,17,29], and only large prospectively followed series can potentially identify MRI findings that are clinically relevant in subgroups of patients. The objective of this trial was to assess (1) the predictive value of standard cervical MRI and (2) the value of repeating MRI after 3 month including sequences with flexion and extension of the cervical spine in a large consecutively enrolled patient population who had been exposed to whiplash injuries.…”