Whiplash: A review of a commonly misunderstood injury

Whiplash injury is a relatively common occurrence, but its mechanism and op timal treatment remain poorly understood. It is estimated that the incidenc e of whiplash injury is approximately 4 per 1,000 persons. The most common radiographic findings include either preexisting degenerative changes or a slight flattening of the normal lordotic curvature of the cervical spine. C omputed tomography and magnetic resonance imaging are generally reserved fo r cases of neurologic deficit, suspected disc or spinal cord damage, fractu re, or ligamentous damage. Biomechanics studies have determined that after rear impact C6 is rotated back into extension before movement of the upper cervical vertebrae. Thus, the lower cervical vertebrae were in extension wh ile the upper vertebrae were in a position of relative flexion, producing a n S shape in the cervical spine. It is believed that this abnormal motion p attern might play a role in the development of whiplash injuries. Historica lly, a soft cervical collar has been used early after the injury in an atte mpt to restrict cervical range of motion and limit the chances of further i njury. More recent studies report rest and restriction of motion to be detr imental and to slow the healing process. (C) 2001 by Excerpta Medica, Inc.