The Anatomy and Biomechanics of Acute and Chronic Whiplash Injury

Abstract

Whiplash injury is the most common motor vehicle injury, yet it is also one of the most poorly understood. Here we examine the evidence supporting an organic basis for acute and chronic whiplash injuries and review the anatomical sites within the neck that are potentially injured during these collisions. For each proposed anatomical site—facet joints, spinal ligaments, intervertebral discs, vertebral arteries, dorsal root ganglia, and neck muscles—we present the clinical evidence supporting that injury site, its relevant anatomy, the mechanism of and tolerance to injury, and the future research needed to determine whether that site is responsible for some whiplash injuries. This article serves as a snapshot of the current state of whiplash biomechanics research and provides a roadmap for future research to better understand and ultimately prevent whiplash injuries.

Keywords:

• Whiplash injury
• Biomechanics
• Neck
• Injury mechanisms
• Tolerance
• Acute and chronic injury

ACKNOWLEDGEMENTS

This review is based on a discussion panel consisting of the authors at the World Congress on Neck Pain, Los Angeles, California, on January 21, 2008. The authors thank Drs. Adrian Lund and Anders Kullgren for their help planning the panel, Dr. Mark White for organizing the conference, and Dr. David Viano for his encouragement to write this article. Funding for portions of this work was provided by the Southern Consortium for Injury Biomechanics/NHTSA subcontract (DTNH-22-04-H-01423) (BAW), the National Center for Injury Prevention and Control (R49CE000689 (BAW) and 1R01CE001257 (PCI)), the National Science Foundation (Grant No. 0547451) (BAW), and the Whitaker Foundation (ANV).