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Lågenergi krock kan ge whiplashskada
Nedan visas en artikel som publicerats i SPINE i april 1999.
Kommentarer följer längst ned på sidan!
TITLE:
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Motion analysis of cervical vertebrae during whiplash loading
[In Process Citation]
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AUTHORS:
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Kaneoka K; Ono K; Inami S; Hayashi K
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AUTHOR AFFILIATION:
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Department of Orthopaedic Surgery, University of Tsukuba,
Japan. koji.kaneoka@nifty.ne.jp
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SOURCE:
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Spine 1999 Apr 15;24(8):763-9; discussion 770
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[MEDLINE record in process]
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CITATION IDS:
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PMID: 10222526 UI: 99239032
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ABSTRACT:
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STUDY DESIGN:
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The motion of each cervical vertebra during simulated rear-end
car collisions was analyzed.
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OBJECTIVES:
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To clarify the mechanism of zygapophysial joint injury during
whiplash loading.
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SUMMARY OF BACKGROUND DATA:
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The zygapophysial joint is the suspected origin of neck pain
after rear-end car collision. However, no studies have been conducted on
the mechanisms of zygapophysial joint injuries.
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METHODS:
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Ten healthy male volunteers participated in this study. Subjects
sat on a sled that glided backward on inclined rails and crashed into a
damper at 4 km/kr. The motion of the cervical spine was recorded using cineradiography.
Each vertebra's rotational angle and the instantaneous axes of rotation
of the C5-C6 motion segments were quantified. These measurements implemented
the template method.
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RESULTS:
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There were three distinct patterns of cervical spine motion
after impact. In the flexion-extension group, C6 rotated backward before
the upper vertebrae in the early phase; thus, the cervical spine showed
a flexion position (initial flexion). After C6 reached its maximum rotational
angle, C5 was induced to extend. As upper motion segments went into flexion,
and the lower segments into extension, the cervical spine took an S-shaped
position. In this position, the C5-C6 motion segments showed an open-book
motion with an upward-shifted instantaneous axis of rotation.
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CONCLUSIONS:
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The cervical spine is forced to move from the lower vertebrae
during rear-end collisions. This motion completely differs from normal extension
motion and is probably related to the injury mechanism.
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- I försöken användes fullt friska män (studenter)
- Dessa var medvetna om vad som skulle hända, dvs det var inga olyckor
(def: Plötslig oförutsedd yttre händelse som drabbar kroppen
- Frågan är om denna studies upplägg överhuvudtaget kan jämföras med en situation
med en oförberedd person i ett verkligt trauma? Det är ifrågasatt av bl.a. dr
Michael B Freeman, dr Arthur Croft mfl.
Man kan i nuläget endast spekulera i hur resultaten blivit om studien kunnat
utformas med
- en representativ befolkningsgrupp, dvs även kvinnor, inte helt friska etc
- oförberedda försökspersoner
"What we can say
for sure is that all low speed accidents don't cause injuries, however some low
speed accidents can cause significant injuries. Only an experienced physician
who has performed a good interview, record review, soft-tissue exam can make this
determination",
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