This content is not included in
your SAE MOBILUS subscription, or you are not logged in.
Influence of DISH, Ankylosis, Spondylosis and Osteophytes on Serious-to-Fatal Spinal Fractures and Cord Injury in Rear Impacts
Technical Paper
2019-01-1028
ISSN: 0148-7191, e-ISSN: 2688-3627
This content contains downloadable datasets
Annotation ability available
Sector:
Language:
English
Abstract
Seats have become stronger over the past two decades and remain more upright in rear impacts. While head restraints are higher and more forward providing support for the head and neck, serious-to-fatal injuries to the thoracic and cervical spine have been seen in occupants with spinal disorders, such as DISH (diffuse idiopathic skeletal hyperostosis), ankylosis, spondylosis and/or osteophytes that ossify the joints in the spine. This case study addresses the influence of spinal disorders on fracture-dislocation and spinal cord injury in rear impacts with relatively upright seats. Nineteen field accidents were investigated where serious-to-fatal injuries of the thoracic and cervical spine occurred with the seat remaining upright or slightly reclined. The occupants were lap-shoulder belted, some with belt pretensioning and cinching latch plate. The occupants were older and had pre-existing disorders of the spine, including DISH, ankylosis, spondylosis and/or osteophytes that ossify the spinal joints. The crashes were summarized and the mechanism for injury was analyzed. The 19 cases involved fracture-dislocation and spinal cord injury at areas of the spine where DISH, ankylosis, spondylosis and/or osteophytes ossified the intervertebral soft tissues causing stiff and brittle joints that were vulnerable to fracture-dislocation by straightening of the spine. Published sled tests at 40 km/h (25 mph) with the 50th Hybrid III showed that peak chest acceleration was 13.5 ± 2.4 g (n=7) and head acceleration was 26.0 ± 12.0 g (n=8). Sled testing at 16 km/h (10 mph) with the BioRID IIg involved T1 x-accelerations of 12.6 ± 2.4 g (n=12) and head x-accelerations of 10.1 ± 0.2 g (n=12). These levels of acceleration are sufficient to fracture the calcified spine of the older occupants without ramping or moving off the support from the seatback and head restraint. A new injury mechanism for spinal fracture-dislocation is described in older occupants with spinal disorders. The occupant remains supported by the relatively upright seatback and high and forward head restraint. The accelerations that bring the occupant up to the delta V are sufficient to fracture-dislocate the calcified spine that tries to straighten in the crash.
Recommended Content
Authors
Topic
Citation
Viano, D., Parenteau, C., and White, S., "Influence of DISH, Ankylosis, Spondylosis and Osteophytes on Serious-to-Fatal Spinal Fractures and Cord Injury in Rear Impacts," SAE Technical Paper 2019-01-1028, 2019, https://doi.org/10.4271/2019-01-1028.Data Sets - Support Documents
| Title | Description | Download |
|---|---|---|
| Unnamed Dataset 1 | ||
| Unnamed Dataset 2 | ||
| Unnamed Dataset 3 | ||
| Unnamed Dataset 4 | ||
| Unnamed Dataset 5 |
Also In
References
- Forestier , J. and Rotes-Querol , J. Senile Ankylosing Hyperostosis of the Spine Ann Rheum Dis 9 321 330 1950
- Belanger , T.A. and Rowe , D.E. Diffuse Idiopathic Skeletal Hyperostosis: Musculoskeletal Manifestations J Am Acad Orthop Surg 9 4 258 267 2001
- Resnick , D. and Niwayama , G. Radiographic and Pathologic Features of Spinal Involvement in Diffuse Idiopathic Skeletal Hyperostosis (DISH) Radiology. 119 559 568 1976
- Resnick , D. , Shaul , S.R. , and Robins , J.M. Diffuse Idiopathic Skeletal Hyperostosis (DISH): Forestier’s Disease with Extraspinal Manifestations Radiology 115 513 524 1975
- Horie , S. , Sawaji , Y. , Endo , K. , Suzuki , H. et al. Factors Associated with Bone Metabolism in Patients with Cervical Ossification of the Posterior Longitudinal Ligament Accompanied with Diffuse Idiopathic Skeletal Hyperostosis SICOT J. 4 7 2018
- Mader , R. Diffuse Idiopathic Skeletal Hyperostosis: A Distinct Clinical Entity IMAJ 5 2003
- Eviatar , E. and Harell , M. Diffuse Idiopathic Skeletal Hyperostosis with Dysphagia [Review] J Laryngol Otol 1987
- Pouchot , J. , Watts , C.S. , Esdaile , J.M. , and Hill , R.O. Sudden Quadriplegia Complicating Ossification of the Posterior Longitudinal Ligament and Diffuse Idiopathic Skeletal Hyperostosis Arthritis Rheum 30 1069 1072 1987
- Oostveen , J.C. , Van der Laar , M.A. , and Tuynman , F.H. Anterior Atlantoaxial Subluxation in a Patient with Diffuse Idiopathic Skeletal Hyperostosis J Rheumatol 23 1441 1444 1996
- Paley , D. , Schwartz , M. , Cooper , P. , Harris , W.R. et al. Fractures of the Spine in Diffuse Idiopathic Skeletal Hyperostosis Clin Orthop Relat Res 267 22 32 1991
- Westerveld , L.A. , Verlaan , J.J. , and Oner , F.C. Spinal Fractures in Patients with Ankylosing Spinal Disorders: A Systematic Review of the Literature on Treatment, Neurological Status and Complications Eur Spine J. 18 2 145 156 2009 Feb
- Hendrix , R.W. , Melany , M. , Miller , F. , and Rogers , L.F. Fracture of the Spine in Patients with Ankylosis Due to Diffuse Skeletal Hyperostosis: Clinical and Imaging Findings AJR Am J Roentgenol. 162 899 904 1994
- Weinfeld , R.M. , Olson , P.N. , Maki , D.D. , and Griffiths , H.J. The Prevalence of Diffuse Idiopathic Skeletal Hyperostosis (DISH) in Two Large American Midwest Metropolitan Hospital Populations Skeletal Radiology 26 4 222 225 1997
- Diederichs , G. , Engelken , F. , Marshall , L.M. , Peters , K. et al. Diffuse Idiopathic Skeletal Hyperostosis (DISH): Relation to Vertebral Fractures and Bone Density Osteoporos Int 22 6 1789 1797 2011
- Cassim , B. , Mody , G.M. , and Rubin , D.L. The Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in African Blacks Br J Rheumatol. 29 2 131 132 1990 1990
- Kim , S.K. , Choi , B.R. , Kim , C.G. et al. The Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in Korea J Rheumatol 31 2032 2035 2004
- Kiss , C. , O’Neill , T.W. , Mituszova , M. et al. The Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in a Population-Based Study in Hungary Scand J Rheumatol 31 226 229 2002
- Littlejohn , G.O. and Smythe , H.A. Marked Hyperinsulinemia After Glucose Challenge in Patients with Diffuse Idiopathic Skeletal Hyperostosis J Rheumatol 8 965±8 1981
- Littlejohn , G.O. and Hall , S. Diffuse Idiopathic Skeletal Hyperostosis and New Bone Formation in Male Gouty Subjects. A Radiologic Study Rheumatol Int 2 83±6 1982
- Vezyroglu , G. , Mitropoulos , A. , Kyriazis , N. , and Antoniadis , C. A Metabolic Syndrome in Diffuse Idiopathic Skeletal Hyperostosis: A Controlled Study J Rheumatol 23 672 676 1996
- Nathan , H. Osteophytes of the Vertebral Column. An Anatomical Study of Their Development According to Age, Race and Sex with Considerations t\as to Their Etiology and Significance The Journal of Bone and Joint Surgery 44A 2 March 1962
- Kumaresan , S. , Yoganandan , N. , Pintar , F. , Maiman , D.J. et al. Contribution of Disc Degeneration to Osteophyte Formation in the Cervical Spine: A Biomechanical Investigation Journal of Orthopedic Research. 19 5 977 984 2001
- Wong , S.H.J. , Chiu , K.Y. , and Yan , C.H. Review Article: Osteophytes Journal of Orthopaedic Surgery. 24 3 403 410 2016
- Cvijeti´c , S. , McCloskey , E. , and Korsi´c , M. Vertebral Osteophytosis and Vertebral Deformities in an Elderly Population Sample Wien Klin Wochenschr 112 407 412 2000
- Matsunaga , S. , Kukita , M. , Hayashi , K. , Shinkura , R. et al. Pathogenesis of Myelopathy in Patients with Ossification of the Posterior Longitudinal Ligament J Neurosurg 96 2 Suppl 168 172 2002
- Song , K.J. , Park , C.I. , Kim , D.Y. , Jung , Y.R. et al. Is OPLL-Induced Canal Stenosis a Risk Factor of Cord Injury in Cervical Trauma? Acta Orthop Belg. 80 4 567 574 2014 Dec
- Koyanagi , I. , Iwasaki , Y. , Hida , K. , Imamura , H. et al. Acute Cervical Cord Injury Associated with Ossification of the Posterior Longitudinal Ligament Neurosurgery. 53 4 887 891 2003
- Davidsson , J. , Deutscher , C. , Hell , W. , Linder , A. et al. Human Volunteer Kinematics in Rear-End Collisions J Crash Prevention and Injury Control. 2 4 319 333 2001
- McConnell , W.E. Van Poppel , H.R.P. , Krause , H.R. Guzman , H.M. et al. Human Head and Neck Kinematics After Low Velocity Rear-End Impacts - Understanding “Whiplash” 39th Stapp Car Crash Conf. 1995 215 238 Society of Automotive Engineers, Warrendale, PA
- Svensson , M.Y. , Lovsund , P. , Haland , Y. , and Larsson , S. Rear-End Collisions - A Study of the Influence of Backrest Properties on Head-Neck Motion Using a New Dummy Neck SAE Technical Paper 930343 1993 10.4271/930343
- Viano , D.C. and Parenteau , C.S. BioRID Dummy Responses in Matched ABTS and Conventional Seat Tests on the IIHS Rear Sled Traffic Injury Prevention 12 339 346 2011
- Viano , D.C. , Parenteau , C.S. , Burnett , R. , and Prasad , P. Occupant Responses in Conventional and ABTS Seats in High-Speed Rear Sled Tests with a Normally Seated Dummy Traffic Injury Prevention 19 2 1 54 59 2018
- Mertz , H.J. , Irwin , A.L. , Melvin , J.W. , Stanaker , R.L. et al. Size, Weight and Biomechanical Impact Response Requirements for Adult Size Small Female and Large Male Dummies SAE Technical Paper 890756 1989 10.4271/890756
- Milne , J.S. and Lauder , I.J. Age Effect in Kyphosis and Lordosis in Adults Annals of Human Biology 1 3 327 337 1974
- Milne , J.S. , Maule , M.M. , and Williamson , J. Method of Sampling in a Study of Older People with a Comparison of Respondents and Non-Respondents British Journal of Preventive and Social Medicine 25 37 41 1971
- Parenteau , C.S. , Zhang , P. , Holcombe , S. , Kohoyda-Inglis , C. Analysis of Morphomics Parameters by Gender and BMI Groups: Thorax Shape and H-point Location Proceedings of the 2013 IRCOBI Conference Gothenburg, Sweden 2013
- Parenteau , C.S. , Zhang , P. , and Holcombe , S. Wang SC Characterization of Vertebral Angle and Torso Depth by Gender and Age Groups with a Focus on Occupant Safety Traffic Inj Prev. 15 1 66 72 2014
- Yoganandan , N. , Ray , G. , Pintar , F.A. , Myklebust , J.B. et al. Stiffness and Strain Energy Criteria to Evaluate the Threshold of Injury to an Intervertebral Joint J Biomech. 22 135 142 1989
- Yamada , H. Evans F.G. Strength of Biological Materials Baltimore, MD The Williams & Williams Company 1970
- Sonoda , T. Studies on the Strength for Compression, Tension, and Torsion of the Human Vertebral Column J Kyoto Pref Med Univ. 71 659 702 1962
- Viano , D.C. , Parenteau , C.S. , and Burnett , R. Thoracic and Lumbar Spine Responses in High-Speed Rear Sled Tests Traffic Injury Prevention 19 5 523 528 2018
- Mata , S. , Fortin , P.R. , Fitzcharles , M.A. et al. A Controlled Study of Diffuse Idiopathic Skeletal Hyperostosis. Clinical Features and Functional Status Medicine 76 104 117 1997
- Legrand , E. , Chappard , D. , Pascaretti , C. , Duquenne , M. et al. Bone Mineral Density and Vertebral Fractures in Men Osteoporos Int. 10 4 265 270 1999
- Johnsson , K.E. , Petersson , H. , Wollheim , F.A. , and Säveland , H. Diffuse Idiopathic Skeletal Hyperostosis (DISH) Causing Spinal Stenosis and Sudden Paraplegia J Rheumatol 10 784 789 1983
- Resnick , D. , Guerra , J. Jr. , Robinson , C.A. , and Vint , V.C. Association of Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Calcification and Ossification of the Posterior Longitudinal Ligament AJR Am J Roentgenol. 131 6 1049 1053 1978 Dec
- Caron , T. , Bransford , R. , Nguyen , Q. , and Agel , J. Spine Fractures in Patients with Ankylosing Spinal Disorders Spine 35 11 E458 E464 2010
- Lyman , S. , Ferguson , S.A. , Braver , E.R. , and Williams , A.F. Older Driver Involvements in Police Reported Crashes and Fatal Crashes: Trends and Projections Inj. Prev. 8 2 116 120 2002
- Li , G. , Braver , E.R. , and Chen , L.H. Fragility Versus Excessive Crash Involvement as Determinants of High Death Rates Per Vehicle-mile of Travel Among Older Drivers Accident Analysis and Prevention 35 227 235 2003
- Evans , L. Traffic Safety and the Driver New York Van Nostrand Reinhold 1991
- Rolison , J.J. , Hewson , P.J. , Hellier , E. , and Husband , P. Risk of Fatal Injury in Older Adult Drivers, Passengers, and Pedestrians J Am Geriatr Soc. 60 8 1504 1508 2012
- Hill , J.D. and Boyle , L. Assessing the Relative Risk of Severe Injury in Automotive Crashes in Older Female Occupants Accident Analysis and Prevention 38 148 154 2006
- Pintar , F.A. , Yoganandan , N. , and Voo , L. Effect of Age and Loading Rate on Human Cervical Spine Injury Threshold Spine 23 18 1957 1962 1998
- Kuppa , S. , Eppinger , F. , McKoy , F. , Nguyen , T. et al. Development of Side Impact Thoracic Injury and Their Application to the Modified ES-2 Dummy with Rib Extension (ES-2re) Stapp Car Crash J. 47 189 210 2003
- Kent , R , Henary , B , and Matsuoka , F. On the Fatal Crash Experience of Older Drivers the 49th Annual Proceedings of the Association for the Advancement of Automotive Medicine 2005 371 379
- Zhou , Q. , Rouhana , S.E. , and Melvin , J.W. Age Effects of Thoracic Injury Tolerance SAE Technical Paper 962421 1996 10.4271/962421
- Maggio , D. , Pacifici , R. , Cherubini , A. , Simonelli , G. et al. Age-related Cortical Bone Loss at the Metacarpal Calcif Tissue Int. 60 1 94 97 1997
- Goh , S. , Tan , C. , Price , R.I. , Edmondston , S.J. et al. Influence of Age and Gender on Thoracic Vertebral Body Shape and Disc Degeneration: An MR Investigation of 169 Cases J Anat. 197 647 657 2000
- Bilston , L.E. , Clarke , E.C. , and Brown , J. Spinal Injury in Car Crashes: Crash Factors and the Effects of Occupant Age Inj Prev. 17 4 228 232 2011 Aug
- Stein , D.M. , Kufera , J.A. , Ho , S.M. , Ryb , G.E. et al. Occupant and Crash Characteristics for Case Occupants with Cervical Spine Injuries Sustained in Motor Vehicle Collisions J Trauma. 70 2 299 309 2011
- Wang , S.C. 2002
- Augenstein , J. Digges , K. Bahouth , G. Dalmotas , D. et al. Investigation of the Performance of Safety Systems for Protection of the Elderly the 49th Annual Proceedings of the Association for the Advancement of Automotive Medicine 2005
- Ridella , S.A. Rupp , J.D. Poland , K. Age-Related Differences in AIS 3+ Crash Injury Risk, Types, Causation and Mechanisms the Proceeding of the IRCOBI conference 2012
- Kent , R. , Lee , S.H. , Darvish , K. , Wang , S. et al. Structural and Material Changes in the Aging Thorax and Their Role in Crash Protection for Older Occupants Stapp Car Crash J 49 231 249 2005
- Cartwright , M.J. , Tchkonia , T. , and Kirkland , J.L. Aging in Adipocytes: Potential Impact of Inherent, Depot-Specific Mechanisms Exp Gerontol. 42 6 463 471 2007
- Viano , D.C. and Parenteau , C.S. Serious Injury in Very-Low and Very-High Speed Rear Impacts SAE Technical Paper 2008-01-1485 2008 10.4271/2008-01-1485
- Bruno , A.G. , Burkharta , K. , Allaireb , B. , Anderson , D.E. et al. Spinal Loading Patterns from Biomechanical Modeling Explain the High Incidence of Vertebral Fractures in the Thoracolumbar Region J Bone Miner Res. 32 6 1282 1290 2017
- Van der Klift , M. , De Laet , C.E. , McCloskey , E.V. , Hofman , A. et al. The Incidence of Vertebral Fractures in Men and Women: The Rotterdam Study J Bone Miner Res 17 6 1051 1056 2002
- Nevitt , M.C. , Cummings , S.R. , Stone , K.L. , Palermo , L. et al. Risk Factors for a First-Incident Radiographic Vertebral Fracture in Women >or= 65 Years of Age: The Study of Osteoporotic Fractures J Bone Miner Res 20 1 131 140 2005
- Stone , K.L. , Seeley , D.G. , Lui , L.Y. , Cauley , J.A. et al. BMD at Multiple Sites and Risk of Fracture of Multiple Types: Long-Term Results from the Study of Osteoporotic Fractures J Bone Miner Res 18 11 1947 1954 2003