| Occupants of a car that is involved in a collision may | | | | This is also true when there is focal neck pain that |
| experience neck pain, no matter which direction the | | | | cannot be explained, or there is a neurological deficit |
| impact comes from; however, this is far more likely to | | | | that does not show up on plain film. |
| occur when the impact comes from the rear. | | | | Additionally, if there is unexplained soft tissue swelling in |
| An eight mile per hour rear-end collision that has a 2-g | | | | the pre-vertebral region or if the plain film is abnormal |
| acceleration (2-g = 2 times the gravitational force of | | | | for any other reason, a CT (computed tomography) or |
| earth) of the vehicle could cause a 5-g acceleration of | | | | MRI (magnetic resonance imaging) is advised. |
| the head. Experiments that used volunteers showed | | | | These tests can reveal soft tissue problems like |
| that a ten mile per hour rear-end collision could | | | | herniated disks, ruptured ligaments, and soft tissue |
| generate a 9-g acceleration of the neck and 23-g of | | | | hematoma. However, CT is limited when it comes to |
| the frontal cortex. | | | | its ability in evaluating cervical trauma. |
| It has been shown that 10-60% of people in a car | | | | Cons of CT Scan: It is not as easy to see dislocations, |
| accident suffer from sprains in the neck. The ones that | | | | subluxations, abnormal angulations, and intervertebral |
| did not wear seat belts have less sprains of the neck | | | | distances using CT as it is using old-fashioned |
| than those wearing them. | | | | radiography or the newer, tomography. In one |
| The incidence of whiplash caused by rear end impacts | | | | research experiment CT just detected 54% of |
| can be significantly reduced by the use of head | | | | dislocations and subluxations of trauma victims. |
| restraints. In fact, the reduction is as much as ten | | | | MRI Scan |
| percent in cars that have adjustable head restraints | | | | MRI data of whiplash injuries vary greatly and differ |
| and seventeen percent in those with fixed head | | | | considering the time period between the x-rays and |
| restraints. | | | | the accident. |
| Plain radiographs (x-ray): | | | | - During the chronic phase, the first year after the |
| They say that plain radiographs should be used first | | | | trauma, usually findings will be non-specific. They will |
| when evaluating a whiplash injury. This is in order to | | | | include degenerative disk disease as well as disk |
| obtain an image for reference of the cervical spine | | | | protrusions and/or herniation. Very few patients show |
| when injured, and in addition, to evaluate possible | | | | bony or ligamentous lesions. |
| lesions that are traumatic. Using this method, | | | | - While experiencing the subacute phase, within four |
| secondary symptoms like degenerative disease can | | | | months of the whiplash incident, more characteristic |
| be assessed objectively, even when they are noted | | | | results such as separations of the disk from the |
| some length of time after the trauma. | | | | vertebral end plate, as well as ligamentous lesions are |
| Cons of X-rays. Additionally, caution that plain | | | | typically reported. When comparing the anterior |
| radiographs may not be entirely effective in the | | | | longitudinal ligament (ALL) and the posterior longitudinal |
| identification of traumatic cervical spine injuries. In a | | | | ligament (PLL) or interspinous ligament, the ALL is more |
| large percentage of patients with cervical injuries, the | | | | frequently injured. |
| combination of cross-table lateral (CTL), AP and | | | | - Often no specific findings will be made during the |
| OM-views had the following results: | | | | fifteen days following the original injury. This phase is |
| Sixty-one percent of all fractures were missed. | | | | often referred to as the acute phase. |
| Thirty-six percent of subluxations and dislocations | | | | - If the patient experiences neurological deficit, |
| were also missed. Additionally, injuries in twenty-three | | | | myelopathy, spinal cord injury, or radiculopathy, an MRI |
| percent of the patients were falsely identified. Half of | | | | (magnetic resonance imaging) may be indicated. This is |
| these patients had unstable cervical injuries, and some | | | | especially true if the symptoms surpass what should |
| had normal cervical spines. | | | | be expected from findings revealed by a standard |
| For this reason, when a trauma victim has a plain film | | | | radiograph. In cases of whiplash injury, it is wise to use |
| that shows cervical injury or a high clinical suspicion of | | | | MRI (magnetic resonance imaging) as standard |
| injury, the patient should have an MRI (magnetic | | | | procedure. This is especially true when the patient |
| resonance imaging) or a CT (computed tomography) | | | | complains of symptoms specific to whiplash injury or if |
| scan. This will give a clearer and more definitive | | | | other investigation reveals significant findings. |
| evaluation of the condition of the cervical spine. | | | | Cons of MRI Scan. Cost. Although in cases of |
| CT scans: | | | | whiplash injury this is taken care of by the insurance |
| A CT scan is a good choice for all patients who have | | | | company. |
| experienced acute trauma. This is especially true when | | | | Neck injuries or whiplash from car accidents respond |
| the cervical spine cannot be seen well utilizing plain film. | | | | very well to chiropractic treatments. |