Biomechanical Aspects of Cervical Spine Injuries 950658

Traffic accident statistics as well as figures from insurance companies indicate an increasing importance of cervical spine injuries. Despite this fact, biomechanical and clinical assessment of these injuries (often classified “minor”) is often compromised by a confusion between the actual findings of the medical examination (for example, distortion, luxation, “soft tissue neck injury”, neck sprain, or other often barely discernible injuries) on one hand and the mechanisms leading to these injuries, such as (hyper-)-flexion, -extension, -translation, or compression, on the other hand. The still widespread, yet misleading, usage of the term “whiplash” is a classical example thereof. A subdivision of the criteria in terms of “accident severity” into four classes, for example dynamic loading of the car, biomechanical loading of the occupant, clinically diagnosable injuries, and subjective sequelae for the victim, is proposed. The cervical spine injury mechanisms known to date are presented. The role of shear forces in the upper cervical articulations (C₀-C₂) as a possible cause for neck injuries in car impacts is discussed as well as its implications on the design of better car seats, for example with automatically positioned head restraints.