1
|
Holsgrove TP, Jaumard NV, Zhu N, Stiansen NS, Welch WC, Winkelstein BA. Upper Cervical Spine Loading Simulating a Dynamic Low-Speed Collision Significantly Increases the Risk of Pain Compared to Quasi-Static Loading With Equivalent Neck Kinematics. J Biomech Eng 2016; 138:2554134. [PMID: 27636191 DOI: 10.1115/1.4034707] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Indexed: 12/23/2022]
Abstract
Dynamic cervical spine loading can produce facet capsule injury. Despite a large proportion of neck pain being attributable to the C2/C3 facet capsule, potential mechanisms are not understood. This study replicated low-speed frontal and rear-end traffic collisions in occiput-C3 human cadaveric cervical spine specimens and used kinematic and full-field strain analyses to assess injury. Specimens were loaded quasi-statically in flexion and extension before and after dynamic rotation of C3 at 100 deg/s. Global kinematics in the sagittal plane were tracked at 1 kHz, and C2/C3 facet capsule full-field strains were measured. Dynamic loading did not alter the kinematics from those during quasi-static (QS) loading, but maximum principal strain (MPS) and shear strain (SS) were significantly higher (p = 0.028) in dynamic flexion than for the same quasi-static conditions. The full-field strain analysis demonstrated that capsule strain was inhomogeneous, and that the peak MPS generally occurred in the anterior aspect and along the line of the C2/C3 facet joint. The strain magnitude in dynamic flexion continued to rise after the rotation of C3 had stopped, with a peak MPS of 12.52 ± 4.59% and a maximum SS of 5.34 ± 1.60%. The peak MPS in loading representative of rear-end collisions approached magnitudes previously shown to induce pain in vivo, whereas strain analysis using linear approaches across the facet joint was lower and may underestimate injury risk compared to full-field analysis. The time at which peak MPS occurred suggests that the deceleration following a collision is critical in relation to the production of injurious strains within the facet capsule.
Collapse
Affiliation(s)
- Timothy P. Holsgrove
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, 210 South 33rd Street, Room 240 Skirkanich Hall, Philadelphia, PA 19104 e-mail:
| | - Nicolas V. Jaumard
- Department of Neurosurgery, Pennsylvania Hospital, University of Pennsylvania, Washington Square West Building, 235 South 8th Street, Philadelphia, PA 19106 e-mail:
| | - Nina Zhu
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, 210 South 33rd Street, Room 240 Skirkanich Hall, Philadelphia, PA 19104 e-mail:
| | - Nicholas S. Stiansen
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, 210 South 33rd Street, Room 240 Skirkanich Hall, Philadelphia, PA 19104 e-mail:
| | - William C. Welch
- Department of Neurosurgery, Pennsylvania Hospital, University of Pennsylvania, Washington Square West Building, 235 South 8th Street, Philadelphia, PA 19106 e-mail:
| | - Beth A. Winkelstein
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, 210 South 33rd Street, Room 240 Skirkanich Hall, Philadelphia, PA 19104
- Department of Neurosurgery, Pennsylvania Hospital, University of Pennsylvania, Washington Square West Building, 235 South 8th Street, Philadelphia, PA 19106 e-mail:
| |
Collapse
|
2
|
Yoganandan N, Stemper BD, Rao RD. Patient Mechanisms of Injury in Whiplash-Associated Disorders. ACTA ACUST UNITED AC 2013. [DOI: 10.1053/j.semss.2012.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|