Research

Deceleration during 'real life' motor vehicle collisions – a sensitive predictor for the risk of sustaining a cervical spine injury?

Martin Elbel^1* , Michael Kramer^1* , Markus Huber-Lang¹ , Erich Hartwig² and Christoph Dehner¹

¹  Center of Surgery, Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University of Ulm, Steinhövelstrasse 9, 89075, Ulm, Germany

²  Department of Trauma Surgery, Deaconesses Hospital, Karlsruhe – Rüppurr, Academic Teaching Hospital of Freiburg University, Diakonissenstrasse 28, 76199, Karlsruhe, Germany

author email corresponding author email* Contributed equally

Patient Safety in Surgery 2009, 3:5doi:10.1186/1754-9493-3-5

Published:	8 March 2009

Abstract

Background

The predictive value of trauma impact for the severity of whiplash injuries has mainly been investigated in sled- and crash-test studies. However, very little data exist for real-life accidents. Therefore, the predictive value of the trauma impact as assessed by the change in velocity of the car due to the collision (ΔV) for the resulting cervical spine injuries were investigated in 57 cases after real-life car accidents.

Methods

ΔV was determined for every car and clinical findings related to the cervical spine were assessed and classified according to the Quebec Task Force (QTF).

Results

In our study, 32 (56%) subjects did not complain about symptoms and were therefore classified as QTF grade 0; 25 (44%) patients complained of neck pain: 8 (14%) were classified as QTF grade I, 6 (10%) as QTF grade II, and 11 (19%) as QTF grade IV. Only a slight correlation (r = 0.55) was found between the reported pain and ΔV. No relevant correlation was found between ΔV and the neck disability index (r = 0.46) and between ΔV and the QTF grade (r = 0.45) for any of the collision types. There was no ΔV threshold associated with acceptable sensitivity and specificity for the prognosis of a cervical spine injury.

Conclusion

The results of this study indicate that ΔV is not a conclusive predictor for cervical spine injury in real-life motor vehicle accidents. This is of importance for surgeons involved in medicolegal expertise jobs as well as patients who suffer from whiplash-associated disorders (WADs) after motor vehicle accidents.

Trial registration

The study complied with applicable German law and with the principles of the Helsinki Declaration and was approved by the institutional ethics commission.