HYPEREXTENSION STRAIN OR WHIPLASH INJURIES TO THE CERVICAL-SPINE

Purpose. To define ''whiplash'' radiologically. Material and Methods. A full cervical spine radiographic series (including flexion and exten sion views) was reviewed in 40 patients with clinically proven ''whipl ash'' injuries and compared to the radiographs in 105 normal controls. The level and degree of kinking or kyphosis, subluxation, and the dif ference in the amount of fanning between spinous processes on flexion and extension films were measured in each patient. Results. Localized kinking greater than 10 degrees and over 12 mm of fanning, often occur ring at the level below the kinking or kyphosis, occurred mainly in th e group of whiplash patients (sensitivity 81%, specificity 76%, accura cy 80%). Conclusions. Localized kinking greater than 10 degrees and fa nning greater than 12 mm are useful measurements by which to separate patients with true whiplash injuries from those with minor ligamentous tears. Flexion and extension views are essential to help define whipl ash and other ligamentous injuries of the cervical spine.