A whiplash injury is one of the most common injuries with car accidents. Often X-rays, bone scans, CT and MRI scans do not show any physical abnormality although clinically this can be a very disabling condition. Most of the time it is best to not use any neck collars, but to remobilize early provided that more serious injuries like fractures or serious unstable ligamentous injuries have been ruled out by the treating physician (Ref. 1).
Apart from car accidents the cervical spine is target for many other injuries such as sports injuries, work injuries, personal injuries and mishaps at home.
The mass of the head, which is supported by the neck, generates a powerful force that can be easily transmitted to the lower end of the cervical spine where most of the impact is felt.
Due to the leverage of the length of the cervical spine this force is magnified and transmitted to the structures there resulting in cervical spine injury. The end results are facet joint subluxations, ligamentous tears, strains (thanks to orthopedics.about.com for the link) or compression fractures of the spine (mostly at the upper and lower end of the cervical spine). When a heavy object falls onto the head, this often will lead to compression fractures of one or more of the vertebral bodies of the cervical spine. In the past no help was available for this, but as the link shows kyphoplasty can be offered in suitable cases today. When the force strikes more from the side of the vertebral body an end plate fracture (thanks to www.gentili.net for the images) may occur as shown here.
Whiplash Injury
References:
1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 2.
2. D Irnich et al. BMJ 2001 Jun 30;322(7302):1574.
3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 140.
4. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
5. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
6. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
