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At least 55 records · Page 3Linked to original sources
PubMed2005

Intervertebral neck injury criterion for simulated frontal impacts.

OBJECTIVE: The Intervertebral Neck Injury Criterion (IV-NIC) is based on the hypothesis that dynamic intervertebral motion beyond physiological limits may injure soft tissues. In contrast, the Neck Injury Criterion (NIC) hypothesizes that sudden change in spinal fluid pressure may cause neural injuries. The goals of this study, using the biofidelic whole human cervical spine model with muscle force replication, were to determine the IV-NIC injury threshold due to frontal impact at each intervertebral level, and to compare the IV-NIC and NIC in determining injury. METHODS: Using a bench-top apparatus, frontal impacts were simulated at 4, 6, 8, and 10 g horizontal accelerations of the T1 vertebra. Pre- and post-trauma flexibility testing measured the soft tissue injury; that is, a significant increase (p < 0.05) in neutral zone or range of motion at any intervertebral level, above the corresponding physiological limit. RESULTS: Results indicated that the soft tissue injury occurred due to flexion mode of injury and its threshold was 8 g. The average IV-NIC injury threshold (95% confidence interval) was 2.0 (1.2-2.8) at C4-C5 and 2.3 (1.6-3.0) at C6-C7, while the average NIC injury threshold was 18.4 (17.9-19.0) m(2)/s(2). The NIC injury threshold was reached significantly earlier than all the IV-NIC injury thresholds, demonstrating that the NIC may be unable to predict facet and soft tissue injury caused by non-physiologic inververtebral rotation. CONCLUSIONS: Present results suggest that IV-NIC is an effective tool for determining soft tissue neck injuries by identifying the intervertebral level, mode, time, and severity of injury.

Acceleration↗
PubMed1986

Head and neck injuries.

A survey of cranial, intracranial and neck injuries caused by blunt trauma to the head is presented. The different types of fractures to the skull (impression fractures, linear fractures and ring fractures) are discussed as well as the injury mechanisms. Brain injuries are discussed under the heading of focal brain injury (i.e. brain laceration, cortical contusion, hemorrhages of the meninges and traumatic intracerebral hemorrhages). The different types of neck injuries, including atlanto-occipital dislocation, are listed and the stability of the different fractures are discussed. Facial injury is not included.

Atlanto-Axial Joint↗
PubMed2007

Screening for catastrophic neck injuries in sports.

The cervical spine is prone to injury due to the structure of the articulating vertebrae at the level of C4-C6, where the spinal cord occupies more of the spinal canal. Cervical spine injuries can occur in all sports and all ages. Participation in contact sports certainly increases the possibility of cervical spine injuries. In screening for catastrophic neck injuries it is vital to examine incidence and injury surveillance statistics in sports. These data can help determine sport-specific preponderance of catastrophic injury. Screening methods for predisposition to catastrophic cervical spine injuries include a concise history, physical examination, and radiographic methods. There is currently no universal classification system utilizing imaging of the cervical spine that has been validated as a screening method for catastrophic neck injuries.

Athletic Injuries↗
PubMed2002

Psychiatry of whiplash neck injury.

BACKGROUND: The psychiatric outcome of whiplash neck injury is controversial. AIMS: To describe outcomes and predictors as compared with other types of road accident injury. METHOD: Consecutive emergency department attenders (n=1148; whiplash 278) assessed by self-report at baseline, 3 months, 1 year and 3 years. RESULTS: Moderate to severe pain was reported by 27% of whiplash sufferers at 1 year and by 30% at 3 years. Psychiatric consequences were common and persistent. Whiplash victims and those with bony injury were more likely to seek compensation. Accident and early post-accident psychosocial variables predicted the pain at 1 year. Claiming compensation at 3 months predicted the pain at 1 year for those with whiplash or bony injury. CONCLUSIONS: There is no special psychiatry of whiplash neck injury. Psychological variables and consequences are important following whiplash in a similar manner to other types of injury.

Accidents, Traffic↗
PubMed1964

A NEW DIAGNOSTIC SIGN IN NECK INJURIES.

The aggravation of neck pain and headache as a result of the use of diathermy or other forms of energy in the treatment of neck sprain may represent a diagnostic sign by which to distinguish severe injury of the neck from simple sprain. In the case of simple neck sprain, the patient's complaints may be inadvertently continued more or less indefinitely by the use of high frequency energy or even locally applied heat. That recovery sometimes follows settlement of litigation in such cases may be due not to the award of money but to discontinuance of an aggravating medical treatment.

Accidents, Traffic↗
PubMed2003

Acute soft tissue neck injury from unexpected acceleration.

Recent evidence has identified a risk of neck injury resulting from exposure to high sustained G force during operation of fast jet military aircraft. This review considers the risk of acute soft tissue neck injury when exposure to acceleration is unexpected by the individual. In a military jet, this might occur to a back seat occupant such as an instructor or weapons operator/navigator, but unexpected forces may also be encountered by roller coaster riders and human centrifuge users under certain conditions. The mechanisms of injury in this situation are examined, the effect of acceleration axes (Gx, Gy, and Gz) are considered, and relevant experimental data are evaluated. These data are used to determine what influence the unexpected nature of the acceleration exposure has on the risk of neck injury. Injury below previously established 'tolerance' limits is possible, with some individuals being at risk from unexpected acceleration exposure above around +2 to .

Aerospace Medicine↗
PubMedDate not supplied

Trends in emergency department reported head and neck injuries among skiers and snowboarders.

BACKGROUND: Reports from the U.S. suggest increases in the proportion and rate of head and neck injuries in skiers and snowboarders. It is important to determine if the same is true in Canada. METHODS: Skiers and snowboarders (< 18 years) presenting to 16 selected emergency departments from 1991 to 1999 were assigned one body region of injury in the following order: i) brain and spine-spinal cord, ii) head and neck, iii) face, iv) other body region (i.e., controls). Crude and adjusted (age, gender, helmet use and hospital admission) odds ratios indicating the proportion of head, brain, face, and neck injury relative to controls by calendar year were estimated. Injury rates were examined for 12 to 17 year olds over the last 4 years of the study. RESULTS: Compared with 1997-1999, there was a lower proportion of skier head injuries from 1991-93 (adjusted odds ratio (AOR) = 0.16; 95% Confidence Interval (CI) = 0.09-0.30) and from 1995-97 (AOR = 0.71; 95% CI = 0.49-1.04). The proportion of skier brain injuries was lower from 1993-95 (AOR = 0.69; 95% CI = 0.44-1.07) and from 1995-97 (AOR = 0.56; 95% CI: 0.35-0.91). In snowboarders, however, compared with 1997-99, there was evidence that although the proportion of head injuries was lower from 1991-93 (AOR = 0.19; 95% CI = 0.05-0.80), the opposite was true for facial injuries. For 12 to 17 year olds, skier brain and snowboarder head and neck injury rates increased from 1995-99. CONCLUSIONS: The results suggest that head and brain injuries in skiers and head and neck injuries in snowboarders may be increasing, particularly in adolescents.

Adolescent↗
PubMed1999

Head and neck injuries in young taekwondo athletes.

BACKGROUND: To investigate the location, type, situation and mechanism of head and neck injuries in young taekwondo athletes. METHODS EXPERIMENTAL DESIGN: Prospective. SETTING: National and international taekwondo tournaments. PARTICIPANTS: 3,341 boys and 917 girls, aged 6 to 16 years. MEASURES: Injury rates per 1,000 athlete-exposures (A-E) for total number of head and neck injuries, location, type, situation, and mechanism of injury. RESULTS: There was a significant difference between young male and female taekwondo athletes in total head and neck injury rate (p < 0.001) with the boys (21.42/1,000 A-E) recording a higher rate than the girls (16.91/1,000 A-E). The head was the most often injured body part (6.10/1,000 A-E and 4.55/1,000 A-E for boys and girls, respectively). The contusion was the most often occurring injury type for both boys (8.41/1,000 A-E) and girls (7.80/1,000 A-E). The cerebral concussion ranked second in both boys (5.11/1,000 A-E) and girls (4.55/1,000 A-E). The unblocked attack was the major injury situation for both boys (19.78/1,000 A-E) and girls (14.96/1,000 A-E). As a consequence, the major injury mechanism was receiving a blow (20.93/1,000 A-E and 16.25/1,000 A-E for boys and girls, respectively). Only the boys (0.66/1,000 A-E) incurred the most serious head and neck injuries that resulted in > or = 21 days away from participation. CONCLUSIONS: The national and international taekwondo governing bodies should review their current injury prevention measures. Given the potentially debilitating nature of these injuries, implications for any diagnostic capabilities on site should be carefully reviewed.

Adolescent↗
PubMed2000

A study of the knowledge that school rugby coaches have in the management and prevention of serious neck injury.

The following study is an analysis of the knowledge school rugby coaches responsible for Senior Cup Team in Leinster, have in the area of neck injury prevention and management. When serious neck injuries affect schoolboys it is particularly tragic and deserves special attention. The study targeted all the coaches of Senior Cup Teams in Leinster. Results showed that coaches lack vital knowledge in the area of neck injury prevention, recognition and management. Only 50% (n = 18) of coaches have a first aid qualification and only 47% (n = 17) carry first aid equipment to deal with neck injuries to matches. More than half of the schools in the study sample do not have neck collars available and a staggering 83% (n = 30) of schools do not have a stretcher available to SCT players. The study highlights the need to provide better first aid facilities in schools and demonstrates the need for further education of school rugby coaches.

Cervical Vertebrae↗
PubMed1997

+GZ-induced neck injuries in Royal Australian Air Force fighter pilots.

+GZ-induced neck injuries are a relatively common occurrence in pilots of high performance fighter aircraft. We surveyed 52 fighter pilots from the Royal Australian Air Force Base at Williamtown via an anonymous questionnaire in order to determine the prevalence and operational significance of these injuries. The pilots flew either the F/A-18 Hornet or the MB326H Macchi. Of the respondents, 44 reported having had a neck injury under +GZ. A higher rate was reported in pilots of the F/A-18. Most of these injuries were simple muscle sprains. There were 20 pilots who reported their neck injury as having interfered with mission completion. Only 12 pilots reported doing any regular neck strengthening exercises, while 33 pilots reported doing preflight neck stretches immediately prior to high +GZ exposure. There were 14 pilots who sought medical attention for their injury, with 9 being taken off flight status for an average of 2 weeks. Air combat maneuvering sorties and the "check six" head position were identified as causal factors by most pilots. This study demonstrates the operational significance of these injuries, and highlights the need for more research into this important aerospace medicine issue.

Adult↗
PubMed2005

Evaluation of the intervertebral neck injury criterion using simulated rear impacts.

The Intervertebral Neck Injury Criterion (IV-NIC) is based on the hypothesis that intervertebral motion beyond the physiological limit may injure spinal soft tissues during whiplash, while the Neck Injury Criterion (NIC) hypothesizes that sudden changes in spinal fluid pressure may cause neural injury. Goals of the present study, using a biofidelic whole cervical spine model with muscle force replication, were to correlate IV-NIC with soft-tissue injury, determine the IV-NIC injury threshold, and compare IV-NIC and NIC. Using a bench-top apparatus, rear-impacts were simulated at 3.5, 5, 6.5, and 8 g horizontal accelerations of the T1 vertebra. Pre- and post-whiplash flexibility tests measured the soft tissue injury threshold, i.e. significant increases in the intervertebral neutral zone (NZ) or range of motion (ROM) above corresponding baseline values. Extension IV-NIC peaks correlated well with NZ and ROM increases at C0-C1 and at C3-C4 through C7-T1 (r=0.64 and 0.62 respectively, p<0.001). Average IV-NIC injury thresholds (95% confidence limits) varied among the intervertebral levels and ranged between 1.5 (1.1, 1.9) at C5-C6 and 3.4 (2.4, 4.4) at C7-T1. The NIC injury threshold was 8.7 (7.7, 9.7) m2/s2, substantially less than the proposed threshold of 15 m2/s2. Results support the use of IV-NIC for determining the cervical spine injury threshold and injury severity. Advantages of IV-NIC include the ability to predict the intervertebral level, mode, severity, and time of the cervical spine soft-tissue injury.

Accidents, Traffic↗
PubMed1999

Relationship of head restraint positioning to driver neck injury in rear-end crashes.

Insurance claims were examined for evidence of neck injuries to drivers of passenger cars struck in the rear. Neck injury rates were significantly lower for male drivers, elderly drivers, and drivers in less severe crashes. Even after accounting for differences in driver demographics and crash severity, neck injury rates were significantly lower for drivers of cars with head restraints that were more likely to be behind the heads of motorists.

Accidents, Traffic↗
PubMed2005

Job strain, iso-strain, and the incidence of low back and neck injuries. A 7.5-year prospective study of San Francisco transit operators.

Work-related musculoskeletal disorders account for the largest single category of lost-time occupational injury or disease episodes in industrialized countries. In this study we analyzed the impact of the psychosocial work environment, conceptualized by the demand-control-support model, on the incidence of low back and neck injury in a cohort of 1221 public transit operators followed for 7 years and 6 months. The two main exposure variables were "job strain" (mismatch of high psychological demands and low decision latitude) and "iso-strain" (job strain plus exposure to low social support at work). Analyses controlled for demographic factors, physical workload, and pain at baseline. For low back injuries, increased hazard rates were found for job strain and iso-strain based on tertiles, with hazard ratios (HR) of 1.30 (95% CI=0.96-1.75) and 1.41 (95% CI=0.98-2.01), respectively. Job strain and iso-strain based on median split or analyzed as continuous variables were not associated with low back injuries. For neck injuries, job strain and iso-strain based on median split showed HRs of 1.27 (95% CI=0.99-1.63) and 1.33 (95% CI=1.01-1.77), respectively. Job strain and iso-strain based on tertiles had HRs of 1.52 (95% CI=1.13-2.05) and 1.73 (95% CI=1.21-2.45), respectively. When analyzed as continuous variables, a one-point increase on the job strain and iso-strain scales led to an 8% (95% CI=0.98-1.19) and 14% (95% CI=1.02-1.27) increased hazard of neck injuries, respectively. This study shows the importance of the psychosocial work environment in the etiology of musculoskeletal injuries among transit operators. Since reviews have shown that psychosocial workplace conditions in this occupational group can be changed, these findings indicate a potential for prevention at the workplace.

Adult↗
PubMed1984

Football shoulder and neck injury: a study of the "stinger".

Twenty football players with preliminary diagnosis of "stinger" were examined and treated. Of the 12 on whom EMGs were performed, all but one were proven to have C6 radiculopathy rather than lateral stretch of brachial plexus. Most frequent mode of injury was neck flexion during tackling by a linebacker. Athletes should not return to competition until abnormal neurologic signs disappear.

Adolescent↗
PubMed2005

Intervertebral neck injury criterion for prediction of multiplanar cervical spine injury due to side impacts.

OBJECTIVE: Intervertebral Neck Injury Criterion (IV-NIC) is based on the hypothesis that dynamic three-dimensional intervertebral motion beyond physiological limits may cause multiplanar injury of cervical spine soft tissues. Goals of this study, using a biofidelic whole human cervical spine model with muscle force replication and surrogate head in simulated side impacts, were to correlate IV-NIC with multiplanar injury and determine IV-NIC injury threshold for each intervertebral level. METHODS: Using a bench-top apparatus, side impacts were simulated at 3.5, 5, 6.5, and 8 g horizontal accelerations of the T1 vertebra. Pre- and post-impact flexibility testing in three-motion planes measured the soft tissue injury, i.e., significant increase (p < 0.05) in neutral zone (NZ) or range of motion (RoM) at any intervertebral level, above corresponding physiological limit. RESULTS: IV-NIC in left lateral bending correlated well with total lateral bending RoM (R = 0.61, P < 0.001) and NZ (R = 0.55, P < 0.001). Additionally, the same IV-NIC correlated well with left axial rotation RoM (R = 0.50, P < 0.001). IV-NIC injury thresholds (95% confidence limits) varied among intervertebral levels and ranged between 1.5 (0.6-2.4) at C3-C4 and 4.0 (2.4-5.7) at C7-T1. IV-NIC injury threshold times were attained beginning at 84.5 ms following impact. CONCLUSIONS: Present results suggest that IV-NIC is an effective tool for determining multiplanar soft tissue neck injuries by identifying the intervertebral level, mode, time, and severity of injury.

Acceleration↗
PubMed2003

Penetrating neck injuries in children: a retrospective review.

OBJECTIVE: Penetrating Neck Injuries (PNI) are uncommon in the pediatric population, but they constitute a significant management challenge. Literature has been scant regarding the evaluation and treatment of such injuries in children. Our objective is to evaluate if physical examination alone is sufficient in the assessment and management of pediatric PNI. DESIGN: Retrospective chart review. SETTING: Pediatric emergency center of an urban emergency department (ED) and level 1 trauma center (TC). PARTICIPANTS: All patients 16 years or younger that had penetrating neck injuries between January 1995 and June 2000. INTERVENTIONS: None. RESULTS: During the study period, a total of 148,000 and 9900 patients were seen in the pediatric ED and the TC, respectively. Thirty-one children (22 males, 9 females) with PNI were identified. The median age was 9.5 years (range of 10 months to 16 years). Most children (81%) with PNI were evaluated in the TC. Motor vehicle crashes accounted for 32% of PNI and gun shot wounds for 23% of cases. Most PNI (84%) occurred in zone II of the neck. Eight patients underwent surgical exploration (25.8%) for platysmal penetration, none of which revealed any vascular injuries. Only 4 patients had barium swallows performed based on physical examination findings. All barium swallows were normal. There were no angiograms performed during the study period. A total of 3 patients died (mortality rate of 9%), all of which had major physical examination findings. CONCLUSION: PNI are infrequent in the pediatric population. Most of the patients in our review presented with minor physical examination findings and did not require exploration or diagnostic studies. Observation of the stable child in our case series was found to be an acceptable choice of management of PNI. Further prospective studies are needed to validate these results.

Accidents, Traffic↗
PubMed1996

Influences of the physical parameters on the risk to neck injuries in low impact speed rear-end collisions.

The current state of neck injuries sustained in car-to-car rear-end collisions were investigated according to recent automobile accident statistical data in Japan. To clarify the neck injury mechanisms for low impact speed car collisions, the newly developed impact sled experiment which simulates actual car impact acceleration was performed using human subjects. In order to measure and analyze the physical parameters such as human head rotational acceleration, neck bending moment, shearing and axial forces, the component measurement method with six-degrees of freedom was applied and demonstrated. Furthermore, relationships among the physical parameters, impact speeds, sitting positions, headrest heights and neck muscle tones applied on the subject's head and neck system were analyzed. These analyses would enable us to comprehend the conditions of the neck muscle tone and the effects of the sitting postures including headrest height, factors which are of vital importance to the understanding of neck injury mechanisms.

Acceleration↗
PubMed1988

Period prevalence of acute neck injury in U.S. Air Force pilots exposed to high G forces.

Neck injury is an unquantified clinical and epidemiological problem in pilots exposed to high G forces. The description and assessment of potential deleterious effects on the cervical vertebrae are important aspects of occupational preventive aerospace medicine. This report presents the findings from a prevalence study of acute neck injury, resulting from high G forces, in pilots of high performance aircraft. A sample of 437 pilots from three different aircraft with varying performance capabilities was surveyed by means of an anonymous questionnaire. Stratified sample data were analyzed to determine the strength of association of injury prevalence with pilot age, type of aircraft, and type of flying environment. Of the surveyed pilots, 50.6% stated they had some type of acute neck injury in the preceding 3-month period. Higher aircraft performance was associated with increased injury prevalence. Increased age was associated with increased prevalence of major injury. Preventive strategies may be helpful in reducing injury frequency and avoiding serious injuries.

Acceleration↗