WHIPLASH INJURY OF THE CERVICAL SPINE 1994

 

Forces inadequate to explain injury

Plopping in a chair and other "perturbations of daily living" produce human head acceleration (g) forces similar to those of low velocity "whiplash-type" motor vehicle accidents. This study[1] is of practical importance to the personal injury lawyer, as the Insurance Corporation of British Columbia, and counterparts in other jurisdictions, are using theoretical accident reconstruction by the principal author,  Dr. M. E. Allen, to discredit opinions of causation offered by physicians treating, and undertaking independent medical examinations of, plaintiffs. More update on this topic as the medical and medicolegal debates progress.

Accident mechanisms

A Swiss study[2] showed that severity of symptoms was associated with three features of accidents:

There was no significant relationship with passenger position in the car, use of seat belt, or the presence of a head restraint.

Psychological effects secondary

In another study[3] by the same team, more than a hundred randomly selected patients were studied at a week, three months and six months after whiplash. Personality traits could not predict the course of recovery. Improvement in sense of well being was associated with recovery from bodily symptoms. Cognitive impairment accompanied the persistence of symptoms. Physical cause of psychological symptoms fitted the results better than psychological cause of physical symptoms.

Neck degeneration irrelevant

A German study[4], an average of 5-6 years after whiplash, compared 30 patients with pre-existing radiological evidence of degeneration of the cervical spine and 30 patients without. Those with degenerative changes were an average of 11 years older, had more acute symptoms and lost their typical back-of-headaches more slowly. There was no significant difference in the chronicity of symptoms or in the progression of numbness/tingling, or of shoulder-arm pain. The authors warn against attributing prolonged symptoms to pre-existing radiological evidence of degenerative change.

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