Effect of Head-Neck Position on Cervical Facet Stretch of Post Mortem Human Subjects during Low Speed Rear End Impacts

Subaxial Cervical Spine Motion With Different Sizes of Head-supported Mass Under Accelerative Forces

INTRODUCTION

The evolution of military helmet devices has increased the amount of head-supported mass (HSM) worn by warfighters. HSM has important implications for spine biomechanics, and yet, there is a paucity of studies that investigated the effects of differing HSM and accelerative profiles on spine biomechanics. The aim of this study is to investigate the segmental motions in the subaxial cervical spine with different sizes of HSM under Gx accelerative loading.

METHODS

A three-dimensional finite element model of the male head-neck spinal column was used. Three different size military helmets were modeled and incorporated into head-neck model. The models were exercised under Gx accelerative loading by inputting low and high pulses to the cervical vertebra used in the experimental studies. Segmental motions were obtained and normalized with respect to the non-HSM case to quantify the effect of HSM.

RESULTS

Segmental motions increased with an increase in velocity at all segments of the spine. Increasing helmet size resulted in larger motion increases. Angulations ranged from 0.9° to 9.3° at 1.8 m/s and from 1.3° to 10.3° at 2.6 m/s without a helmet. Helmet increased motion between 5% to 74% at 1.8 m/s. At 2.6 m/s, the helmet increased segmental motion anywhere from 10% to 105% in the subaxial cervical spine. The greatest motion was seen at the C5-C6 level, followed by the C6-C7 level.

CONCLUSIONS

The subaxial cervical spine experiences motion increases at all levels at both velocity profiles with increasing HSM. Larger helmet and greater impact velocity increased motion at all levels, with C5-C6 demonstrating the largest range of motion. HSM should be minimized to reduce the risk of cervical spine injury to the warfighter.

Biomechanical Responses and Injury Assessment of Post Mortem Human Subjects in Various Rear-facing Seating Configurations

The objective of this study was to generate biomechanical corridors from post-mortem human subjects (PMHS) in two different seatback recline angles in 56 km/h sled tests simulating a rear-facing occupant during a frontal vehicle impact. PMHS were placed in a production seat which included an integrated seat belt. To achieve a repeatable configuration, the seat was rigidized in the rearward direction using a reinforcing frame that allowed for adjustability in both seatback recline angle and head restraint position. The frame contained instrumentation to measure occupant loads applied to the head restraint and seatback. To measure PMHS kinematics, the head, spine, pelvis, and lower extremities were instrumented with accelerometers and angular rate sensors. Strain gages were attached to anterior and posterior aspects of the ribs, as well as the mid-shaft of the femora and tibiae, to determine fracture timing. A chestband was installed at the mid sternum to quantify chest deformation. Biomechanical corridors for each body and seat location were generated for each recline angle to provide data for quantitatively evaluating the biofidelity of ATDs and HBMs. Injuries included upper extremity injuries, rib fractures, pelvis fractures, and lower extremity injuries. More injuries were documented in the 45-degree recline case than in the 25-degree recline case. These injuries are likely due to the excessive ramping up and corresponding kinematics of the PMHS. Biomechanical corridors and injury information presented in this study could guide the design of HBMs and ATDs in rigid, reclined, rear-facing seating configurations during a high-speed frontal impact.

Rebound after rear impacts

OBJECTIVE

A number of field accident studies have found that rebound is a source for occupant injury after rear impacts. Sled tests were run to investigate occupant kinematics and rebound, including head velocity and displacement with 3 different seats, 2 conventional seat designs, and 1 all belts to seat (ABTS).

METHODS

Nine rear-end sled tests were run with a belted 50th Hybrid III dummy on a Taurus, Mustang, or Sebring ABTS seat in nominally 16.5, 24.1, and 32.5 km/h rear-end delta Vs. There was no sled braking after the rear acceleration to study rebound from the seat. Dummy kinematics were analyzed from high-speed video and biomechanical responses from triaxial head and chest accelerations, triaxial upper and lower neck loads and moments, and seat belt loads. Peak responses were tabulated during seat back rotation rearward and rebound forward. Ratios of biomechanical and kinematic responses were determined comparing ABTS to conventional seat responses for each delta V. Student's t-test was used to determine significant differences between the ratios of ABTS to conventional seat responses.

RESULTS

The rebound velocity of the head varied from 2.9 to 6.8 m/s with respect to the sled. Overall, it was 69 ± 22 percent higher than the sled delta V. It was greatest with ABTS in the highest severity test where seat back yielding absorbed energy and reduced rebound in the conventional seats. The time to maximum forward excursion was significantly shorter with ABTS compared to the conventional seats with a ratio of 0.54 ± 0.34 (t = 6.13, df = 5, P < .001).

CONCLUSIONS

ABTS seats remain more upright in rear-end crashes and transfer greater load to the occupant during rebound than conventional seats that yield rearward and absorb energy in higher severity crashes. Rebound occurs earlier and at higher velocities with ABTS. This displaces the occupant toward the front interior. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

Kinematics of the thoracoabdominal contents under various loading scenarios

High-speed biplane x-ray was used to investigate relative kinematics of the thoracoabdominal organs in response to blunt loading. Four post-mortem human surrogates instrumented with radiopaque markers were subjected to eight crash- specific loading scenarios, including frontal chest and abdominal impacts, as well as driver-shoulder seatbelt loading. Testing was conducted with each surrogate perfused, ventilated, and positioned in an inverted, fixed-back configuration. Displacement of radiopaque markers recorded with high-speed x-ray in two perspectives was tracked using motion analysis software and projected into calibrated three-dimensional coordinates. Internal organ kinematics in response to blunt impact were quantified for the pericardium, lungs, diaphragm, liver, spleen, stomach, mesentery, and bony structures. These data can be used to better understand the interaction of anatomical structures during impact and the associated injury mechanisms, and for the development or validation of human body finite element models.

Neck injury tolerance under inertial loads in side impacts

Neck injury remains a major issue in road safety. Current side impact dummies and side impact crashworthiness assessments do not assess the risk of neck injury. These assessments are limited by biofidelity and knowledge regarding neck injury criteria and tolerance levels in side impacts. Side impact tests with PMHS were performed at the Heidelberg University in the 1980s and 1990s to improve primarily the understanding of trunk dynamics, injury mechanisms and criteria. In order to contribute to the definition of human tolerances at neck level, this study presents an analysis of the head/neck biomechanical parameters that were measured in these tests and their relationship to neck injury severity. Data from 15 impact tests were analysed. Head accelerations, and neck forces and moments were calculated from 9-accelerometer array head data, X-rays and anthropometric data. Statistically significant relationships were observed between resultant head acceleration and neck force and neck injury severity. The average resultant head acceleration for AIS 2 neck injuries was 112 g, while resultant neck force was 4925 N and moment 241 Nm. The data compared well to other test data on cadavers and volunteers. It is hoped that the paper will assist in the understanding of neck injuries and the development of tolerance criteria.

Cervical facet capsular ligament yield defines the threshold for injury and persistent joint-mediated neck pain

The cervical facet joint has been identified as a source of neck pain, and its capsular ligament is a likely candidate for injury during whiplash. Many studies have shown that the mechanical properties of ligaments can be altered by subfailure injury. However, the subfailure mechanical response of the facet capsular ligament has not been well defined, particularly in the context of physiology and pain. Therefore, the goal of this study was to quantify the structural mechanics of the cervical facet capsule and define the threshold for altered structural responses in this ligament during distraction. Tensile failure tests were preformed using isolated C6/C7 rat facet capsular ligaments (n=8); gross ligament failure, the occurrence of minor ruptures and ligament yield were measured. Gross failure occurred at 2.45+/-0.60 N and 0.92+/-0.17 mm. However, the yield point occurred at 1.68+/-0.56 N and 0.57+/-0.08 mm, which was significantly less than gross failure (p<0.001 for both measurements). Maximum principal strain in the capsule at yield was 80+/-24%. Energy to yield was 14.3+/-3.4% of the total energy for a complete tear of the ligament. Ligament yield point occurred at a distraction magnitude in which pain symptoms begin to appear in vivo in the rat. These mechanical findings provide insight into the relationship between gross structural failure and painful loading for the facet capsular ligament, which has not been previously defined for such neck injuries. Findings also present a framework for more in-depth methods to define the threshold for persistent pain and could enable extrapolation to the human response.

Development of numerical models for injury biomechanics research: a review of 50 years of publications in the Stapp Car Crash Conference

Numerical analyses frequently accompany experimental investigations that study injury biomechanics and improvements in automotive safety. Limited by computational speed, earlier mathematical models tended to simplify the system under study so that a set of differential equations could be written and solved. Advances in computing technology and analysis software have enabled the development of many sophisticated models that have the potential to provide a more comprehensive understanding of human impact response, injury mechanisms, and tolerance. In this article, 50 years of publications on numerical modeling published in the Stapp Car Crash Conference Proceedings and Journal were reviewed. These models were based on: (a) author-developed equations and software, (b) public and commercially available programs to solve rigid body dynamic models (such as MVMA2D, CAL3D or ATB, and MADYMO), and (c) finite element models. A clear trend that can be observed is the increasing use of the finite element method for model development. A review of these modeling papers clearly indicates the progression of the state-of-the-art in computational methods and technologies in injury biomechanics.

Tensile cervical facet capsule ligament mechanics: failure and subfailure responses in the rat

Clinical, epidemiological, and biomechanical studies suggest the involvement of the cervical facet joint in neck pain. Mechanical studies have suggested the facet capsular ligament to be at risk for subfailure tensile injury during whiplash kinematics of the neck. Ligament mechanical properties can be altered by subfailure injury and such loading can induce cellular damage. However, at present, there is no clear understanding of the physiologic context of subfailure facet capsular ligament injury and mechanical implications for whiplash-related pain. Therefore, this study aimed to define a relationship between mechanical properties at failure and a subfailure condition associated with pain for tension in the rat cervical facet capsular ligament. Tensile failure studies of the C6/C7 rat cervical facet capsular ligament were performed using a customized vertebral distraction device. Force and displacement at failure were measured and stiffness and energy to failure were calculated. Vertebral motions and ligament deformations were tracked and maximum principal strains and their directions were calculated. Mean tensile force at failure (2.96 +/- 0.69 N) was significantly greater (p < 0.005) than force at subfailure (1.17 +/- 0.48 N). Mean ligament stiffness to failure was 0.75 +/- 0.27 N/mm. Maximum principal strain at failure (41.3 +/- 20.0%) was significantly higher (p = 0.003) than the corresponding subfailure value (23.1 +/- 9.3%). This study determined that failure and a subfailure painful condition were significantly different in ligament mechanics and findings provide preliminary insight into the relationship between mechanics and pain physiology for this ligament. Together with existing studies, these findings offer additional considerations for defining mechanical thresholds for painful injuries.

Motion Analysis of the Mandible during Low-Speed, Rear-End Impacts using High-Speed X-rays

There has been much debate over "whiplash"-induced temporomandibular joint (TMJ) dysfunction following low-speed, rear-end automobile collisions. While several authors have reported TMJ injury based on case studies post collision, there has been little biomechanical evidence showing that rear-end impact was the primary cause of such injury. The purpose of this study was to measure the relative translation between the upper and lower incisors in cadavers subjected to low-speed, rearend impacts. High-speed x-ray images used for this analysis were reported previously for the analysis of cadaveric cervical spine kinematics during low-speed, rear-end impacts. The cadavers were positioned at various seatback angles and body postures, producing an overall picture of various seating scenarios. Of the 38 tests conducted using 10 cadavers, there were seven tests from three cadavers in which the positions of the upper and lower incisors could be tracked with precision using imageprocessing software. The relative protrusion, retrusion, and mouth opening were computed from these seven sets of data, providing a better understanding of TMJ motion. Based on this limited data, the average maximum protrusion, retrusion and mouth opening were 1.6+/-1.8, 1.1+/-0.7, and 1.2+/-1.2 mm, respectively. These values appear to fall within normal physiological limits experienced during daily activities such as mastication. It is concluded that low-speed, rear-end automobile collisions do not appear to create the motion required to initiate injury to the TMJ.