This content is not included in your SAE MOBILUS subscription, or you are not logged in.
Likelihood of Spinal Disc Herniations in Occupants Involved in Real World Side Impacts
ISSN: 0148-7191, e-ISSN: 2688-3627
Published April 14, 2020 by SAE International in United States
This content contains downloadable datasetsAnnotation ability available
The prevalence of spinal disc herniations in people with no spinal symptoms have been reported to increase with age; from about 20% in those below 40 years to about 30% in those above 40 years. Spinal disc herniations are usually associated with degenerative changes. Though rare, spinal disc herniations can also be caused by trauma. With an increasing number of older people on U.S. roads with a concomitant increase in the probability of getting injured in a vehicle collision, it is reasonable to expect that some of these occupants can present with clinical findings of spinal disc herniations after a side impact, and attribute these findings to the impact. In this study, we looked at the relationship between real world side impacts and the occurrence of spinal injuries, in particular disc herniations, in occupants involved in such impacts. We examined the reported occurrence of all spine injuries in side impact crashes in the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS) database from 1993 through 2014. There were over 8,400 adult raw case occupants, corresponding to a weighted number of approximately 4.7 million that fit the inclusion criteria. The results showed that the most common spine injury in side impact is acute muscle strain of the cervical spine, followed by acute muscle strain of the lumbar spine. The total number of occupants with reported spinal disc herniations was only three; all from near-side impacts. The low prevalence of reported spinal disc herniations stands in sharp contrast to a background prevalence of 20% to 30% in asymptomatic individuals. The findings from the real world data in this study, in light of known spinal responses in experiments conducted on post-mortem human subjects (PMHSs) and anthropomorphic test devices (ATDs) exposed to near- and far-side impacts, suggest that side impacts do not present a mechanism of traumatic disc herniation.
CitationLam, T. and Ivarsson, B., "Likelihood of Spinal Disc Herniations in Occupants Involved in Real World Side Impacts," SAE Technical Paper 2020-01-0526, 2020, https://doi.org/10.4271/2020-01-0526.
Data Sets - Support Documents
|[Unnamed Dataset 1]|
|[Unnamed Dataset 2]|
|[Unnamed Dataset 3]|
|[Unnamed Dataset 4]|
|[Unnamed Dataset 5]|
- Pintar, F., Yoganandan, N., and Stemper, B. , “Comparison of PMHS, WorldSID and THOR-NT Responses in Simulated Far Side Impact,” Stapp Car Crash Journal 51:313-360, 2007.
- Augenstein, J., Bowen, J., Perdeck, E. et al. , “Injury Patterns in Near-Side Collisions,” SAE Technical Paper 2000-01-0634, 2000, https://doi.org/10.4271/2000-01-0634.
- AAAM , Abbreviated Injury Scale, 2005 Revision (Barrington, IL: Association for the Advancement of Automotive Medicine, 2005).
- Gabler, H., Digges, K., Fildes, B. et al. , “Side Impact Injury Risk for Belted Far-Side Passenger Vehicle Occupants,” SAE Technical Paper 2005-01-0287, 2005, https://doi.org/10.4271/2005-01-0287.
- Suderman, B., Scher, I., and Ching, R. , “Likelihood of Lumbar Spine Injuries for Far-Side Occupants in Low to Moderate Speed Lateral Impacts,” SAE Technical Paper 2014-01-0494, 2014, https://doi.org/10.4271/2014-01-0494.
- Moore, K. and Dalley, A. , Clinically Oriented Anatomy Fifth Edition (Lippincott Williams and Wilkins, 2006).
- Adams, M. and Hutton, W. , “The Mechanics of Prolapsed Intervertebral Disc,” International Orthopaedics 6(4):249-253, 1982, doi:10.1007/bf00267146.
- Brinckmann, P. , “Injury of the Annulus Fibrosus and Disc Protrusions,” Spine 11(2):149-153, 1986, doi:10.1097/00007632-198603000-00009.
- Adams, M. and Hutton, W. , “The Effect of Fatigue on the Lumbar Intervertebral Disc,” Journal of Bone & Joint Surgery (Br) 65B(2):199-203, 1983.
- Adams, M. and Hutton, W. , “Gradual Disc Prolapse,” Spine 10(6):524-531, 1985, doi:10.1097/00007632-198507000-00006.
- Battie, C., Videman, T., and Parent, E. , “Lumbar Disc Degeneration: Epidemiology and Genetic Influences,” Spine 29(23):2679-2690, 2004, doi:10.1097/01.brs.0000146457.83240.eb.
- Boden, S., McCowin, P., Davis, D. et al. , “Abnormal Magnetic-Resonance Scans of the Cervical Spine in Asymptomatic Subjects. A Prospective Investigation,” Journal of Bone and Joint Surgery (Am) 72:1178-1184, 1990.
- Matsumoto, M., Fujimara, Y., Suzuki, N. et al. , “MRI of Cervical Intervertebral Discs in Asymptomatic Subjects,” Journal of Bone and Joint Surgery (Br) 80-B:19-24, 1998, doi:10.1302/0301-620x.80b1.7929.
- Boden, S., McCowin, P., Davis, D. et al. , “Abnormal Magnetic Resonance Scans of the Lumbar Spine in Asymptomatic Subjects: A Prospective Investigation,” Journal of Bone and Joint Surgery (Am) 72A:403-408, 1990.
- Jensen, M., Brant-Zawadzki, M., Obuchowski, N. et al. , “Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain,” New England Journal of Medicine 331:69-73, 1994, doi:10.1056/NEJM199407143310201.
- Jarvik, J., Hollingsworth, W., Heagerty, P. et al. , “The Longitudinal Assessment of Imaging and Disability of the Back (Laidback) Study,” Spine 26(10):1158-1166, 2001, doi:10.1097/00007632-200105150-00014.
- Brinjikji, P., Luetmer, B., Comstock, 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.
- Furbish, C., Welcher, J., Brink, J. et al. , “Occupant Kinematics and Loading in Low Speed Lateral Impacts,” SAE Technical Paper 2019-01-1027, 2019, https://doi.org/10.4271/2005-01-0287.
- Fildes, B., Sparke, L., Bostrom, O. et al , “Suitability of Current Side Impact Test Dummies in Far-Side Impacts,” in Proceedings of the International IRCOBI Conference, Munich, 2002.
- Page, M. , “Performance of the Prototype WorldSID Dummy in Side Impact Crash Tests,” in Proceedings of the 17th International Conference on the Enhanced Safety of Vehicles, Netherlands, 2001.
- Yoganandan, N., Pintar, F., Maiman, D. et al. , “Neck Forces and Moments and Head Accelerations in Side Impact,” Traffic Injury Prevention 10(1):51-57, 2009, doi:10.1080/15389580802524876.
- Fugger, T., Randles, B., Wobrock, J. et al. , “Human Occupant Kinematics in Low Speed Side Impacts,” SAE Technical Paper 2002-01-0020, 2002, https://doi.org/10.4271/2002-01-0020.
- NHTSA , “National Automotive Sampling System - Crashworthiness Data System,” 2012 Analytical User’s Manual, U.S. Department of Transportation, DOT HS 811 830.
- Matsumoto, M., Okada, E., Ichihara, I. 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. Third Edition. (Churchill Livingston, 2013).
- Pintar, F., Sances, A., Yoganandan, N. et al. , “Biodynamics of the Total Human Cadaveric Cervical Spine,” SAE Technical Paper 902309, 1990, https://doi.org/10.4271/902309.