Spinal Disc Herniations in Occupants involved in Frontal Impacts

Paper #:
  • 2018-01-0545

  • 2018-04-03
Disc herniations in the spine are commonly associated with degenerative changes, and the prevalence increases with increasing age. Though rare, spinal disc herniations can also be caused by trauma. With increasing number of older people on U.S. roads, there is an expected proportionate increase in clinical findings of disc herniations in occupants involved in vehicle impacts. We endeavor to determine in this study whether there is a causal relationship between frontal impacts and the occurrence of spinal injuries, in particular disc herniations, in the occupants of these impacts. We examined the reported occurrence of all spine injuries in the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) database from 1993 through 2014. There were over 34,000 adult occupants that fit the inclusion criteria. The findings in this study showed that, in the weighted data of 17.6 million adult occupants, the most common spine injury is an acute muscle strain of the neck, followed by strain of the low back. The delta-V of a frontal impact is a reliable indicator of the rate of acute cervical strain in occupants exposed to such impacts. The number of occupants with disc herniations was relatively small in the three segments of the spine: 15 occupants with neck disc herniations, 2 in the thoracic spine, and 3 in the lumbar spine for the 34,911 raw cases, in contrast to a background prevalence of 20 to 30 % disc abnormalities in asymptomatic individuals. It appears that the known experimental mechanism of causing a traumatic disc herniation by hyperflexion and axial compression is unlikely to be operative during a frontal impact. The findings from the real world data in this study, in light of the known experimental mechanism to produce a traumatic disc herniation, appear to suggest that there is no causal link between frontal impacts and traumatic disc herniations in the spine of occupants exposed to such impacts.
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