![]() ![]() At the time of publication, this was the longest follow-up study on whiplash-injured patients. (2002) looked at the health status of whiplash-injured patients 17 years after injury. The authors documented that 70 percent of the patients continued to complain of symptoms referable to the original accident.īunketorp, et al. reviewed the long-term status of whiplash-injured patients 15.5 years after injury. In fact, after two years, symptoms did not alter with further passage of time, remaining chronic.Ī 1996 study by Squires, et al. Of these residual symptoms, 28 percent were intrusive and 12 percent were severe, indicating that 40 percent of whiplash-injured patients continued to suffer from significant residual symptoms more than a decade after being injured. Of these, only 12 percent had recovered completely and 88 percent suffered from residual symptoms. In a study looking at long-term status of whiplash-injured patients (Gargan, 1990), researchers reviewed 43 patients who had sustained soft-tissue injuries of the neck after a mean 10.8 years. Spinal degeneration and signal lesions may persist for months to years. Alar ligament changes were unrelated to age and type of trauma. Vetti, et al (2009) showed that there is strong evidence for causal relationship between trauma and alar ligament lesions. Numerous research studies have looked at acute and long-term consequences of whiplash injuries. ![]() Acutely, injured ligament permits influx of edema or hemorrhage, which, on MRI, is seen as bright areas interspersed within dark collagen fibers. Such tightened, anteroposteriorly-oriented alar ligaments are more vulnerable to hyperextension-hyperflexion trauma than relaxed, transversely oriented ligaments. Reaching 90° rotation, these ligaments are maximally tightened and obtain an anteroposterior orientation. When the head rotates, the alar ligaments twist around the dens. The alar ligaments are particularly vulnerable to neck trauma when the head is rotated at the moment of impact. In contrast to elastic fibers, which can tolerate elongation up to 200 percent before failure, collagen ligaments will fail at only eight percent elongation consequently the alar ligaments are particularly vulnerable to traumatic stretching loads. Alar ligaments consist primarily of collagen proteins with a few elastic fibers. ![]() The alar ligaments connect the odontoid process (dens) of the axis vertebrae (C2) to the occipital condyles of the occiput bone of the skull. A main stabilizing ligament of the cranial-cervical region is the alar ligament. ![]() This joint possesses great mobility, but at a price of reduced stability and increased vulnerability to injury. They have greater vulnerability to injury because, while 5 percent of the rotation of the cervical spine occurs at the Occiput-C1 joint and 40 percent of the rotation of the cervical spine occurs at C2-C7, 55 percent of cervical spine (neck) rotation (turning to the right or left) occurs at the atlas-axis joint (C1-C2). The upper cervical spine and the cranial-cervical junction are a mechanically unique region of the spinal column. The exam, the “MRI of the Cranio-Vertebral Junction,” is a completely separate exam from a routine cervical spine study.Ī general biomechanical principle includes the understanding that there is a trade-off between mobility and stability. The injuries are identified using MRI techniques specifically designed for the evaluation of post-traumatic injuries. Plain cervical radiographs are usually normal following whiplash injury. Forceful forward movement of the head compresses the discs and may produce considerable pain and instability. When the head moves backward, the ligaments in the front of the cervical spine are stretched and the bones and joints in the back of the neck are compressed. Motor-vehicle accidents often produce forceful back-and-forth displacement (whiplash) of the head on the neck. ![]()
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