An Overview of CervicalFacet Injury Due to Rear-Impact AutomobileAccidents

DR. BARRY L. MARKS

PRACTICE OF CHIROPRACTIC---

EMPHASIS ONAUTOMOBILE INJURIES

ORANGE, CALIFORNIA

(714) 938-0575

“S” Shape Spine the Source of Damage toCervical Facet Joints in “Whiplash”Injuries

In 1997 MM Panjabi and JN Grauer of the Dept. ofOrthopaedics and Rehabilitation at Yale University School ofMedicine conducted “whiplash” studies on human cadavers.The cadavers were subjected to forces simulating a rear-impactautomobile collision while high speed motion x-rays caught theeffects on film. Researchers made a startling new discovery. Itwas always thought that hyperextension occurred in the neck,which resulted in “whiplash” injuries. This study in 1997 foundthat the lower vertebrae of the neck (C5-6) actually changedtheir axis of motion and spun backwards causing their posterior joints (facets) to collide, while the top of the neck was bentforward momentarily. At a given point into the collision, the neckactually formed an “S-shape”.This study found much attention and in 1998 Panjabi MM,Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J and BarHF repeated the study at the Yale University School of Medicineonly this time using live human subjects. The principles of the1997 study were able to replicate the results of the previous teston live human volunteers. The same “S-shaped” configurationwas noted and the lower cervical facet extension was noted.The test was performed at various collision speeds to find thehuman tolerance for such an injury. The results were shocking.The “S-shape” configuration was observed in speeds as low as2.5 mph!In 1999 Koji Kaneoka, Koshiro Ono, Satoshi Inami and KoichiroHayashi of the Department of Orthopedic Surgery at theUniversity of Tsukuba, Japan repeated the second Panjabistudy, again on live human volunteers. The results were the

same. This third study confirmed for the world of spinalresearchers the mechanism by which human spines aredamaged in rear-impact automobile collisions.

Panjabi MM, Grauer JN (1997): "Whiplash produces a S-shape curvature of the neckwith hyperextension at lower levels. " Spine

(21): 2489-94.Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J, Bar HF (1998-12-01): "[Biomechanics of whiplash injury]." Orthopade 1998 Dec; 27(12): 813-9.Koji Kaneoka, Koshiro Ono, Satoshi Inami and Koichiro Hayashi (99-04-15). "Motionanalysis of cervical vertebrae during whiplash loading." Spine