This content is not included in
your SAE MOBILUS subscription, or you are not logged in.
Thoracic Spine Extension Injuries in Occupants with Pre-Existing Conditions during Rear-End Collisions
Technical Paper
2019-01-1222
ISSN: 0148-7191, e-ISSN: 2688-3627
This content contains downloadable datasets
Annotation ability available
Sector:
Language:
English
Abstract
Certain ankylosing spondyloarthropathies such as ankylosing spondylitis (AS) or diffuse idiopathic skeletal hyperostosis (DISH) can substantially alter clinicopathologic spine biomechanics as well as injury mechanisms in rear-end motor vehicle collisions. AS is an inflammatory disease which can lead to structural impairments of the spine secondary to flowing ossification along the spinal column, including ossification across the spinal discs, facet joints, and ligaments, and it has also been associated with diffuse osteoporosis of the spine. DISH is characterized by excess bone formation along the spinal column, encompassing the annulus and forming the thickest and strongest bridging osteophytes over adjacent vertebral bodies at the level of the disc space. In both conditions the spine is mechanically stiffened and generally more kyphotic than a healthy spine. This paper presents a series of case studies in which a front-seat occupant with ankylosing spondyloarthropathy experienced a moderate- or high-speed rear-end collision and sustained a thoracic spine fracture/dislocation, often with spinal cord injuries. Forward acceleration of the occupant by the seat back in each case resulted in straightening of the kyphotic thoracic spine and consequent extension fractures of the pathologically stiff and brittle thoracic spine. This paper illustrates the predisposition of thoracic fracture for this segment of the population with spinal pathologies such as DISH and AS in rear impacts and notes the role that seat back stiffness could play in injury mechanism for these individuals.
Recommended Content
Authors
Citation
Davis, M., Isaacs, J., Graber, M., and Fisher, J., "Thoracic Spine Extension Injuries in Occupants with Pre-Existing Conditions during Rear-End Collisions," SAE Technical Paper 2019-01-1222, 2019, https://doi.org/10.4271/2019-01-1222.Data Sets - Support Documents
Title | Description | Download |
---|---|---|
Unnamed Dataset 1 | ||
Unnamed Dataset 2 |
Also In
References
- Dakwar , E. , Reddy , J. , Vale , F.L. , and Uribe , J.S. A Review of the Pathogenesis of Ankylosing Spondylitis Neurosurg Focus 24 1 1 5 2008 10.3171/FOC/2008/24/1/E2
- Braun , J. and Sieper , J. Ankylosing Spondylitis The Lancet 369 9570 1379 1390 2007 10.1016/S0140-6736(07)60635-7
- Gelman , M.I. and Umber , J.S. Fractures of the Thoracolumbar Spine in Ankylosing Spondylitis American Journal of Roentgenology 130 3 485 491 1978 10.2214/ajr.130.3.485
- Feldtkeller , E. , Vosse , D. , Geusens , P. , and van der Linden , S. Prevalence and Annual Incidence of Vertebral Fractures in Patients with Ankylosing Spondylitis Rheumatology International 26 3 234 239 2006 10.1007/s00296-004-0556-8
- Olivieri , I. , D’Angelo , S. , Palazzi , C. , Padula , A. et al. Diffuse Idiopathic Skeletal Hyperostosis: Differentiation from Ankylosing Spondylitis Current Rheumatology Reports 11 5 321 2009 10.1007/s11926-009-0046-9
- Forestier , J. and Rotés-Querol , J. Senile Ankylosing Hyperostosis of the Spine Annals of the Rheumatic Diseases 9 4 321 330 1950 10.1136/ard.9.4.321
- Belanger , T.A. and Rowe , D.E. Diffuse Idiopathic Skeletal Hyperostosis: Musculoskeletal Manifestations Journal of the American Academy of Orthopaedic Surgeons 9 4 258 267 2001 10.5435/00124635-200107000-00006
- Vaishya , R. , Vijay , V. , Nwagbara , I.C. , and Agarwal , A.K. Diffuse Idiopathic Skeletal Hyperostosis (DISH) - A Common but Less Known Cause of Back Pain Journal of Clinical Orthopaedics and Trauma 8 2 191 196 2017 10.1016/j.jcot.2016.11.006
- Nascimento , F.A. , Gatto , L.A.M. , Lages , R.O. , Neto , H.M. et al. Diffuse Idiopathic Skeletal Hyperostosis: A Review Surgical Neurology International 5 Suppl. 3 S122 S125 2014 10.4103/2152-7806.130675
- Meyer , P.R. Jr. Diffuse Idiopathic Skeletal Hyperostosis in the Cervical Spine Clinical Orthopaedics and Related Research 359 49 57 1999 10.1097/00003086-199902000-00006
- Resnick , D. , Shaul , S.R. , and Robins , J.M. Diffuse Idiopathic Skeletal Hyperostosis (DISH): Forestier’s Disease with Extraspinal Manifestations Radiology 115 3 513 524 1975 10.1148/15.3.513
- Crubézy , E. Diffuse Idiopathic Skeletal Hyperostosis: Diagnosis and Importance in Paleopathology Journal of Paleopathology 3 2 107 117 1989
- Harris , J. , Carter , A. , Glick , E. , and Storey , G. Ankylosing Hyperostosis. I. Clinical and Radiological Features Annals of the Rheumatic Diseases 33 3 210 1974 10.1136/ard.33.3.210
- Kim , S.-K. , Choi , B.-R. , Kim , C.-G. , Chung , S.-H. et al. The Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in Korea The Journal of Rheumatology 31 10 2032 2035 2004
- Kim , B.-S. , Moon , M.-S. , Yoon , M.G. , Kim , S.-T. et al. Prevalence of Diffuse Idiopathic Skeletal Hyperostosis Diagnosed by Whole Spine Computed Tomography: A Preliminary Study Clinics in Orthopedic Surgery 10 1 41 46 2018 10.4055/cios.2018.10.1.41
- Toyoda , H. , Terai , H. , Yamada , K. , Suzuki , A. et al. Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in Patients with Spinal Disorders Asian Spine Journal 11 1 63 70 2017 10.4184/asj.2017.11.1.63
- Hirasawa , A. , Wakao , N. , Kamiya , M. , Takeuchi , M. et al. The Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in Japan - The First Report of Measurement by CT and Review of the Literature Journal of Orthopaedic Science 21 3 287 290 2016 10.1016/j.jos.2016.02.001
- 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 doi.org/10.1007/s00256005022
- Cassim , B. , Mody , G. , and Rubin , D. The Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in African Blacks Rheumatology 29 2 131 132 1990 10.1093/rheumatology/29.2.131
- Holton , K.F. , Denard , P.J. , Yoo , J.U. , Kado , D.M. et al. Diffuse Idiopathic Skeletal Hyperostosis and Its Relation to Back Pain among Older Men: the MrOS Study Seminars in Arthritis and Rheumatism 41 2 131 138 2011 10.1016/j.semarthrit.2011.01.001
- Westerveld , L.A. , van Ufford , H.M.Q. , Verlaan , J.-J. , and Oner , F.C. The Prevalence of Diffuse Idiopathic Skeletal Hyperostosis in an Outpatient Population in The Netherlands The Journal of Rheumatology 35 8 1635 1638 2008
- Kagotani , R. , Yoshida , M. , Muraki , S. , Oka , H. et al. Prevalence of Diffuse Idiopathic Skeletal Hyperostosis (DISH) of the Whole Spine and Its Association with Lumbar Spondylosis and Knee Osteoarthritis: The ROAD Study Journal of Bone and Mineral Metabolism 33 2 221 229 2015 10.1007/s00774-014-0583-9
- Boachie-Adjei , O. and Bullough , P.G. Incidence of Ankylosing Hyperostosis of the Spine (Forestier’s Disease) at Autopsy Spine 12 8 739 743 1987
- Mata , S. , Fortin , P.R. , Fitzcharles , M.-A. , Starr , M.R. et al. A Controlled Study of Diffuse Idiopathic Skeletal Hyperostosis. Clinical Features and Functional Status Medicine 76 2 104 117 1997 10.1097/00005792-199703000-00003
- Bransford , R.J. , Koller , H. , Caron , T. , Zenner , J. et al. Cervical Spine Trauma in Diffuse Idiopathic Skeletal Hyperostosis: Injury Characteristics and Outcome with Surgical Treatment Spine 37 23 1923 1932 2012 10.1097/BRS.0b013e31825b17fc
- Kiss , C. , Szilagyi , M. , Paksy , A. , and Poor , G. Risk Factors for Diffuse Idiopathic Skeletal Hyperostosis: A Case-Control Study Rheumatology 41 1 27 30 2002 10.1093/rheumatology/41.1.27
- Mader , R. , Sarzi-Puttini , P. , Atzeni , F. , Olivieri , I. et al. Extraspinal Manifestations of Diffuse Idiopathic Skeletal Hyperostosis Rheumatology 48 12 1478 1481 2009 10.1093/rheumatology/kep308
- Irwin , Z.N. , Arthur , M. , Mullins , R.J. , and Hart , R.A. Variations in Injury Patterns, Treatment, and Outcome for Spinal Fracture and Paralysis in Adult versus Geriatric Patients Spine 29 7 796 802 2004 10.1097/01.BRS.0000119400.92204.B5
- Byrnes , M.C. , McDaniel , M.D. , Moore , M.B. , Helmer , S.D. et al. The Effect of Obesity on Outcomes among Injured Patients The Journal of Trauma: Injury, Infection, and Critical Care 58 2 232 237 2005 10.1097/01.TA.0000152081.67588.10
- Denko , C.W. and Malemud , C.J. Body Mass Index and Blood Glucose: Correlations with Serum Insulin, Growth Hormone, and Insulin-Like Growth Factor-1 Levels in Patients with Diffuse Idiopathic Skeletal Hyperostosis (DISH) Rheumatology International 26 4 292 297 2006 10.1007/s00296-005-0588-8
- Hollis , S. , Lecky , F. , Yates , D.W. , and Woodford , M. The Effect of Pre-existing Medical Conditions and Age on Mortality after Injury The Journal of Trauma: Injury, Infection, and Critical Care 61 5 1255 1260 2006 10.1097/01.ta.0000243889.07090.da
- Westerveld , L. , Verlaan , J. , and Oner , F. Spinal Fractures in Patients with Ankylosing Spinal Disorders: A Systematic Review of the Literature on Treatment, Neurological Status and Complications European Spine Journal 18 2 145 156 2009 10.1007/s00586-008-0764-0
- Quagliano , P.V. , Hayes , C.W. , and Palmer , W.E. Vertebral Pseudoarthrosis Associated with Diffuse Idiopathic Skeletal Hyperostosis Skeletal Radiology 23 5 353 355 1994 10.1007/BF02416992
- Paley , D. , Schwartz , M. , Cooper , P. , Harris , W.R. et al. Fractures of the Spine in Diffuse Idiopathic Skeletal Hyperostosis Clinical Orthopaedics and Related Research 267 22 32 1991 10.1097/00003086-199106000-00004
- 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 American Journal of Roentgenology 162 4 899 904 1994 10.2214/ajr.162.4.8141015
- Malik , S. , Murphy , M. , Connolly , P. , and O’Byrne , J. Evaluation of Morbidity, Mortality and Outcome Following Cervical Spine Injuries in Elderly Patients European Spine Journal 17 4 585 591 2008 10.1007/s00586-008-0603-3
- Hitchon , P.W. , From , A.M. , Brenton , M.D. , Glaser , J.A. et al. Fractures of the Thoracolumbar Spine Complicating Ankylosing Spondylitis Journal of Neurosurgery: Spine 97 2 218 222 2002 10.3171/spi.2002.97.2.0218
- Karasick , D. , Schweitzer , M. , Abidi , N. , and Cotler , J. Fractures of the Vertebrae with Spinal Cord Injuries in Patients with Ankylosing Spondylitis: Imaging Findings American Journal of Roentgenology 165 5 1205 1208 1995 10.2214/ajr.165.5.7572504
- Murray , G.C. and Persellin , R.H. Cervical Fracture Complicating Ankylosing Spondylitis: A Report of Eight Cases and Review of the Literature The American Journal of Medicine 70 5 1033 1041 1981 10.1016/0002-9343(81)90860-3
- Pettersson , T. , Laasonen , L. , Leirisalo-Repo , M. , and Tervahartiala , P. Spinal Pseudoarthrosis Complicating Ankylosing Spondylitis: A Report of Two Patients Rheumatology 35 12 1319 1323 1996 10.1093/rheumatology/35.12.1319
- Vosse , D. , Feldtkeller , E. , Erlendsson , J. , Geusens , P. et al. Clinical Vertebral Fractures in Patients with Ankylosing Spondylitis The Journal of Rheumatology 31 10 1981 1985 2004 w.1136/ard 2008.100503
- Wang , Y.-F. , Teng , M.M.-H. , Chang , C.-Y. , Wu , H.-T. et al. Imaging Manifestations of Spinal Fractures in Ankylosing Spondylitis American Journal of Neuroradiology 26 8 2067 2076 2005
- Wu , P. , Fang , D. , Ho , E. , and Leong , J. The Pathogenesis of Extensive Discovertebral Destruction in Ankylosing Spondylitis Clinical Orthopaedics and Related Research 230 154 161 1988 10.1097/00003086-198805000-00015
- Hunter , T. and Dubo , H.I. Spinal Fractures Complicating Ankylosing Spondylitis Arthritis & Rheumatism 26 6 751 759 1983 10.1002/art.1780260608
- Weinstein , P.R. , Karpman , R.R. , Gall , E.P. , and Pitt , M. Spinal Cord Injury, Spinal Fracture, and Spinal Stenosis in Ankylosing Spondylitis Journal of Neurosurgery 57 5 609 616 1982 10.3171/jns.1982.57.5.0609
- Shih , T.T.-F. , Chen , P.-Q. , Li , Y.-W. , and Hsu , C.-Y. Spinal Fractures and Pseudoarthrosis Complicating Ankylosing Spondylitis: MRI Manifestation and Clinical Significance Journal of Computer Assisted Tomography 25 2 164 170 2001 10.1097/00004728-200103000-00002
- Fang , D. , Leong J.C.-Y. , Ho E. , Chan F. , et al. Spinal Pseudarthrosis in Ankylosing Spondylitis. Clinicopathological Correlation and the Results of Anterior Spinal Fusion The Journal of Bone and Joint Surgery 70B 3 443 447 1988 10.1302/0301-620X.70B3.3372569
- Burkus , K.J. and Denis , F. Hyperextension Injuries of the Thoracic Spine in Diffuse Idiopathic Skeletal Hyperostosis. Report of Four Cases The Journal of Bone & Joint Surgery 76 2 237 243 1994 10.2106/00004623-199402000-00010
- Hannallah , D. , White , A.P. , Goldberg , G. , and Albert , T.J. Diffuse Idiopathic Skeletal Hyperostosis Operative Techniques in Orthopaedics 17 3 174 177 2007 10.1053/j.oto.2007.03.001
- Hunter , T. , Forster , B. , and Dvorak , M. Ankylosed Spines Are Prone to Fracture Canadian Family Physician 41 1213 1995
- Netter , F.H. Atlas of Human Anatomy, Professional Edition E-Book Elsevier Health Sciences 2014
- Trent , G. , Armstrong , G. , and O'neil , J. Thoracolumbar Fractures in Ankylosing Spondylitis. High-Risk Injuries Clinical Orthopaedics and Related Research 227 61 66 1988 10.1097/00003086-198802000-00009
- Hunter , T. and Dubo , H. Spinal Fractures Complicating Ankylosing Spondylitis Annals of Internal Medicine 88 4 546 549 1978 10.7326/0003-4819-88-4-546
- Prasad , P. , Kim , A. , Weerappuli , D. , Roberts , V. et al. Relationships Between Passenger Car Seat Back Strength and Occupant Injury Severity in Rear End Collisions: Field and Laboratory Studies SAE Technical Paper 973343 1997 10.4271/973343
- Burnett , R. , Carter , J. , Roberts , V. , and Myers , B. The Influence of Seatback Characteristics on Cervical Injury Risk in Severe Rear Impacts Accident Analysis & Prevention 36 4 591 601 2004 10.1016/S0001-4575(03)00066-6
- Viano , D.C. , Parenteau , C.S. , Prasad , P. , and Burnett , R. Stiff versus Yielding Seats: Analysis of Matched Rear Impact Tests SAE Technical Paper 2007-01-0708 2007 10.4271/2007-01-0708
- 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
- Viano , D.C. , Parenteau , C.S. , Burnett , R.A. , and James , M.B. Influence of Seating Position on Dummy Responses with ABTS Seats in Severe Rear Impacts SAE Technical Paper 2009-01-0250 2009 10.4271/2009-01-0250
- Papadopoulos , M.C. , Chakraborty , A. , Waldron , G. , and Bell , B.A. Lesson of the Week: Exacerbating Cervical Spine Injury by Applying a Hard Collar British Medical Journal 319 7203 171 172 1999 10.1136/bmj.319.7203.171
- Callahan , E.P. and Aguillera , H. Complications Following Minor Trauma in a Patient with Diffuse Idiopathic Skeletal Hyperostosis Annals of Emergency Medicine 22 6 1067 1070 1993 10.1016/S0196-0644(05)82754-4
- Smith , B.A. and Griffin , C. Klippel-Feil Syndrome Annals of Emergency Medicine 21 7 876 879 1992 10.1016/S0196-0644(05)81038-8
- Vaidyanathan , S. , Hughes , P.L. , Soni , B.M. , Singh , G. et al. Klippel-Feil Syndrome - The Risk of Cervical Spinal Cord Injury: A Case Report BMC Family Practice 3 1 6 2002 10.1186/1471-2296-3-6
- Strax , T. and Baran , E. Traumatic Quadriplegia Associated with Klippel-Feil Syndrome: Discussion and Case Reports Archives of Physical Medicine and Rehabilitation 56 8 363 365 1975
- Elster , A. Quadriplegia after Minor Trauma in the Klippel-Feil Syndrome. A Case Report and Review of the Literature 66 9 1473 1474 1984 10.2106/00004623-198466090-00026
- Yamasaki , K. , Hoshino , M. , Omori , K. , Igarashi , H. et al. Risk Factors of Adjacent Segment Disease after Transforaminal Inter-Body Fusion for Degenerative Lumbar Disease Spine 42 2 E86 E92 2017 10.1097/BRS.0000000000001728
- Xia , X.-P. , Chen , H.-L. , and Cheng , H.-B.J.S. Prevalence of Adjacent Segment Degeneration after Spine Surgery: A Systematic Review and Meta-Analysis Spine 38 7 597 608 2013 10.1097/BRS.0b013e318273a2ea
- Orndorff , D.G. , Samartzis , D. , Whitehill , R. , and Shen , F.H. Traumatic Fracture-Dislocation of C5 on C6 through a Previously Solid Multilevel Anterior Cervical Discectomy and Fusion: A Case Report and Review of the Literature The Spine Journal 6 1 55 60 2006 10.1016/j.spinee.2005.06.014
- Mac Millan , M. and Stauffer , E.S. Traumatic Instability in the Previously Fused Cervical Spine Journal of Spinal Disorders 4 4 449 454 1991 10.1097/00002517-199112000-00007
- White , A.A. III and Panjabi , M.M. The Clinical Biomechanics of Spine Pain Lippincott-Raven 1990
- Viano , D.C. Fracture-Dislocation of the Thoracic Spine in Extension by Upright Seats in Severe Rear Crashes SAE Technical Paper 2011-01-0274 2011 10.4271/2011-01-0274
- Chan , F. , Ho , E. , and Chau , E. Spinal Pseudarthrosis Complicating Ankylosing Spondylitis: Comparison of CT and Conventional Tomography American Journal of Roentgenology 150 3 611 614 1988 10.2214/ajr.150.3.611
- Luken , M.G. , Patel , D.V. , and Ellman , M.H. Symptomatic Spinal Stenosis Associated with Ankylosing Spondylitis Neurosurgery 11 5 703 705 1982 10.1227/00006123-198211000-00017
- Sarzi-Puttini , P. and Atzeni , F. New Developments in Our Understanding of DISH (Diffuse Idiopathic Skeletal Hyperostosis) Current Opinion in Rheumatology 16 3 287 292 2004 10.1097/00002281-200405000-00021
- Ladd , A. and Scranton , P. Congenital Cervical Stenosis Presenting as Transient Quadriplegia in Athletes. Report of Two Cases The Journal of Bone & Joint Surgery 68 9 1371 1374 1986 10.2106/00004623-198668090-00009
- Torg , J.S. , Corcoran , T.A. , Thibault , L.E. , Pavlov , H. et al. Cervical Cord Neurapraxia: Classification, Pathomechanics, Morbidity, and Management Guidelines Journal of Neurosurgery 87 6 843 850 1997 10.3171/jns.1997.87.6.0843
- Miller , J. and Smith , T. Seatbelt Induced Chance Fracture in an Infant Pediatric Radiology 21 8 575 577 1991 10.1007/BF02012601
- Chance , G. Note on a Type of Flexion Fracture of the Spine The British Journal of Radiology 21 249 452 453 1948 10.1259/0007-1285-21-249-452
- AlJallaf , M. , AlDelail , H. , and Hussein , L. 2015 10.1136/bcr-2014-206924
- Ashman , C.J. , Joseph , S.Y. , and Chung , C.B. The Chance Fracture: Anteroposterior Radiographic Signs Emergency Radiology 4 5 320 325 1997 10.1007/BF01461739
- Bernstein , M.P. , Mirvis , S.E. , and Shanmuganathan , K. Chance-Type Fractures of the Thoracolumbar Spine: Imaging Analysis in 53 Patients American Journal of Roentgenology 187 4 859 868 2006 10.2214/AJR.05.0145
- Durel , R. , Rudman , E. , and Milburn , J. Clinical Images-A Quarterly Column: Chance Fracture of the Lumbar Spine The Ochsner Journal 14 1 9 11 2014
- Kingsbury-Smith , R. Chance and His Fracture Trauma 10 1 13 15 2008 10.1177/1460408607088631
- Inaba , K. , Kirkpatrick , A. , Finkelstein , J. , Murphy , J. et al. Blunt Abdominal Aortic Trauma in Association with Thoracolumbar Spine Fractures Injury 32 3 201 207 2001 10.1016/S0020-1383(00)00203-5
- Ghavam , C. and Kirkpatrick , J.S. Extension-Distraction Fracture of the First Lumbar Vertebra Spine 20 9 1080 1083 1995 10.1097/00007632-199505000-00017
- Holdsworth , F. Fractures, Dislocations, and Fracture-Dislocations of the Spine The Journal of Bone and Joint Surgery 45-B 1 6 20 1963 10.1302/0301-620X.45B1.6
- Imler , S.M. , Heller , M.F. , Raasch , C.C. , Watson , H.N. et al. The Effect of Rear Impact Collision Delta-V and Restraint Status on Injury Outcome SAE Technical Paper 2014-01-0524 2014 10.4271/2014-01-0524