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Spinal Disc Herniations in Occupants Involved in Frontal Impacts
ISSN: 0148-7191, e-ISSN: 2688-3627
Published April 3, 2018 by SAE International in United States
This content contains downloadable datasetsAnnotation ability available
Disc herniations in the spine are commonly associated with degenerative changes, and the prevalence increases with age. Though rare, spinal disc herniations can also be caused by trauma. With increasing number of older drivers on U.S. roads, there is an expected proportionate increase in clinical findings of disc herniations in occupants involved in vehicle impacts. Our goal in this study is to determine whether there is a causal relationship between frontal impacts and the occurrence of disc herniations in the occupants of these impacts. We further aim to determine the prevalence of different types of spinal injury and to evaluate the effects of crash severity and other parameters on different types of spinal injury in such impacts. Using data from the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) database from 1993 through 2014, we examined the reported occurrence of all spine injuries for adult occupants in frontal impact. The results show that the most common spine injury is an acute muscle strain of the neck, followed by strain of the low back. The delta-V of a frontal impact is a significant predictor of acute cervical strain. The number of occupants with disc herniations was relatively small in the three segments of the spine: 15 occupants with neck disc herniations, 3 in the thoracic spine, and 3 in the lumbar spine for the 34,911 raw cases, in contrast to a background prevalence of 10 to 30% spinal disc herniations in asymptomatic individuals. In light of known neck responses of restrained volunteers and post mortem human subjects (PMHS) during frontal impacts, the low prevalence of neck disc herniations observed in the present study can be explained by an absence of the known experimental mechanism of a combination of axial compression and hyperflexion to produce a traumatic disc herniation. The thoracolumbar spine, on the other hand, experiences compression during a frontal impact, suggestive of a possible mechanical environment to produce a traumatic disc herniation. However, the low prevalence of thoracolumbar disc herniations in the present study can be explained by the fact that vertebral body fractures are more likely to occur under similar conditions because the endplate of the vertebral body is the weaker link. The mechanism to produce compression in the thoracolumbar spine during frontal vehicular impacts is unclear and needs to be further investigated.
CitationLam, T. and Ivarsson, B., "Spinal Disc Herniations in Occupants Involved in Frontal Impacts," SAE Technical Paper 2018-01-0545, 2018, https://doi.org/10.4271/2018-01-0545.
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- Moore, K. and Dalley, A., “Clinically Oriented Anatomy, 5th Edition,” (Philadelphia, Lippincott Williams and Wilkins, 2006).
- Adams, M. and Hutton, W., “The Mechanics of the Prolapsed Intervertebral Disc,” International Orthopedics 6(4):249-253, 1982.
- Brinckman, P., “Injury of the Annulus Fibrosus and Disc Protrusions. An In Vitro Investigation on Human Lumbar Discs,” Spine 11(2):149-153, 1986.
- Adams, M. and Hutton, W., “The Effect of Fatigue on the Lumbar Intervertebral Disc,” Journal of Bone & Joint Surgery (Br) 65-B(2):199-203, 1983.
- Adams, M. and Hutton, W., “Gradual Disc Prolapse,” Spine 10(6):524-531, 1985.
- Battie, C., Videman, T., and Parent, E., “Lumbar Disc Degeneration: Epidemiology and Genetic Influences,” Spine 29(23):2679-2690, 2004.
- Boden, S., McCowin, P., Davis, D., Dina, T. et al., “Abnormal Magnetic-Resonance Scans of the Cervical Spine in Asymptomatic Subjects. A Prospective Investigation,” Journal of Bone and Joint Surgery (Am) 72A(8):1178-1184, 1990.
- Matsumoto, M., Fujimara, Y., Suzuki, N., Nishi, Y. et al., “MRI of Cervical Intervertebral Discs in Asymptomatic Subjects,” Journal of Bone and Joint Surgery (Br) 80B(1):19-24, 1998.
- Boden, S., Davis, D., Dina, T., Patronas, N. et al., “Abnormal Magnetic Resonance Scans of the Lumbar Spine in Asymptomatic Subjects. A Prospective Investigation,” Journal of Bone and Joint Surgery (Am) 72A(3):403-408, 1990.
- Jensen, M., Brant-Zawadzki, M., Obuchowski, N., Modic, M. et al., “Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain,” New England Journal of Medicine 331(2):69-73, 1994.
- Jarvik, J., Hollingsworth, W., Heagerty, P., Haynor, D. et al., “The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) Study,” Spine 26(10):1158-1166, 2001.
- Brinjikji, P., Luetmer, B., Comstock, B., Bresnahan, B. et al., “Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations,” American Journal of Neuroradiology 36(4):811-816, 2015, doi:10.3174/ajnr.A4173.
- NCSA, “Traffic Safety Facts, National Center for Statistics and Analysis of the National Highway Traffic Safety Administration,” U.S. Department of Transportation, 2004.
- NCSA, “Traffic Safety Facts, National Center for Statistics and Analysis of the National Highway Traffic Safety Administration,” U.S. Department of Transportation, 2014.
- Begeman, P., King, A., and Prasad, P., “Spinal Loads Resulting from -Gx Acceleration,” SAE Technical Paper 730977, 1973, doi:10.4271/730977.
- Bendixen, C., “Final Report: Daisy Track Human Tolerance Tests,” Department of Transportation, 6571st Aeromedical Research Laboratory, Holloman AFB, New Mexico, 1970.
- Chandler, R. and Christian, R., “Crash Testing of Humans in Automobile Seats,” SAE Technical Paper 700361, 1970, doi:10.4271/700361.
- Ewing, C., Thomas, D., Patrick, L., Beeler, G. et al., “Living Human Dynamic Response to -Gx Impact Acceleration. II. Accelerations Measured in the Head and Neck,” SAE Technical Paper 690817, 1969, doi:10.4271/690817.
- Glenn, T., “Anthropomorphic Dummy and Human Volunteer Tests of Advanced and/or Passive Belt Restraint Systems,” SAE Technical Paper 740579, 1974, doi:10.4271/740579.
- Lopez-Valdez, F., Lau, A., Lamp, J., Riley, P. et al., “Analysis of Spinal Motion and Loads during Frontal Impacts. Comparison between PMHS and ATD,” Annals of Advances in Automotive Medicine 54:61-78, 2010.
- Mertz, H. and Patrick, L., “Strength and Response of the Human Neck,” SAE Technical Paper 710855, 1971, doi:10.4271/710855.
- Rao, R., Berry, C., Yoganandan, N., Agarwal, A. et al., “Occupant and Crash Characteristics in Thoracic and Lumbar Spine Injuries Resulting from Motor Vehicle Collisions,” Spine Journal 14(10):2355-2365, 2014, doi:10.1016/j.spinee.2014.01.038.
- Thunnissen, J., Wismans, J., Ewing, C., and Thomas, D., “Human Volunteer Head-Neck Response in Frontal Flexion: A New Analysis,” SAE Technical Paper 952721, 1995, doi:10.4271/952721.
- Araszewski, M. and Toor, A., “Head, Hip and Knee Velocities of Restrained Occupants in Frontal Impacts,” SAE Technical Paper 2003-01-0884, 2003, doi:10.4271/2003-01-0884.
- Armstrong, R. and Waters, H., “Testing Programs and Research on Restraint Systems,” SAE Technical Paper 690247, 1969, doi:10.4271/690247.
- NHTSA, “National Automotive Sampling System - Crashworthiness Data System. 2012 Analytical User's Manual,” U.S. Department of Transportation DOT HS 811 830, 2013.
- AAAM Abbreviated Injury Scale, 2005 Revision. Association for the Advancement of Automotive Medicine, Barrington, IL, 2005.
- Richards, D., Carhart, M., Raasch, C., Pierce, J. et al., “Incidence of Thoracic and Lumbar Injuries for Restrained Occupants in Frontal Collisions,” Annual Proceedings of the Association for the Advancement of Automotive Medicine 50:125-139, 2006.
- Stapp, J., “Voluntary Human Tolerance Levels,” Impact Injury and Protection, Chapter XV, Editor Thomas C., 1970.
- Matsumoto, M., Okada, E., Ichihara, I., Watanabe, K. et al., “Age-Related Changes of Thoracic and Cervical Intervertebral Discs in Asymptomatic Subjects,” Spine 35(14):1359-1364, 2010, doi:10.1097/BRS.0b013e3181c17067.
- Adams, M., Bogduk, N., Burton, K. et al., “Chapter 11: Mechanical Damage to the Thoracolumbar Spine & Chapter 12: Cervical Spine Biomechanics,” . In: The Biomechanics of Back Pain. 3rd Edition. (Edinburgh, Churchill Livingston, 2013).
- Pintar, F., Sances, A., Yoganandan, N., Reinartz, J. et al., “Biodynamics of the Total Human Cadaveric Cervical Spine,” SAE Technical Paper 902309, 1990, doi:10.4271/902309.
- Pintar, F., Yoganandan, N., Maiman, D., Scarboro, M. et al., “Thoracolumbar Spine Fractures in Frontal Impact Crashes,” Annals of Advances in Automotive Medicine 56:277-283, 2012.