Rear impacts and traumatic disc herniations in the spine: any basis for causation?

Paper #:
  • 2017-01-1458

Published:
  • 2017-03-28
Abstract:
Traumatic disc herniation in the spine is an uncommon event and is usually accompanied by destruction of the vertebral bodies adjacent to them. In contrast, disc herniation associated with spinal degeneration is prevalent, especially with increasing age. With the common occurrence of vehicle rear impacts, a frequent issue is whether such an impact can be causally related to spinal disc herniation. We have surveyed the NASS-CDS database from 1993 through 2014 for reports of spinal disc herniation in occupants involved in single-event rear impacts. In the neck, we found that the most commonly reported injury resulting from a rear impact is a muscle strain. With increasing severity, bony fractures (although few in number) have been reported. There were a few reported disc herniations in the neck but there was no objective validation of a disc herniation resulting from the rear impact, and the occurrence did not follow a dose-response relationship. A similar trend is also seen in the lumbar spine. There were no reported disc herniations in the thoracic spine. The results of this analysis support what is generally known biomechanically about the cause of a disc herniation; a disc herniation is produced as a result of axial compression and hyperflexion, and a vehicle rear impact is unlikely to provide these conditions. This appears to be true even at increasing impact severities.
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