PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Review Article

Volume 1 Issue 3

Whiplash Injuries: An Interventional Approach

Bilal F. Shanti*, Ihsan F Shanti and Zaynab IF Shanti

February 28, 2023

DOI : 10.56831/PSSRP-01-017

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Abstract

Whiplash-associated disorders (WAD) occur when shifting and movement of energy, during a crash or collision, from acceleration-deceleration mechanism is transferred to the neck region. WAD is characterized by excessive extension-flexion movements, and/or excessive side bending of the head and neck, beyond the normal and regular range of motion.

     Motor vehicle collisions remain the majority of trauma responsible for WAD, nevertheless, other causes include contact sports injuries, falls, physical and domestic abuse, and other types of traumas.

     Clinical features and presentations are variable. In general, these includes neck pain, decreased range of motion at cervical spine, spasms, and tightness, headaches, arm(s) numbness or achiness, and other symptoms and signs depending on the extent of the insult. These range from fractures, joint dislocations, ligament tears, and even traumatic brain injuries/post-concussional syndrome, with its subsequent clinical sequalae.

     The trauma associated with WAD outcome can result in acute and chronic pain syndromes, functionality limitations and restrictions, psychological and psychosocial ramifications, financial crisis, unemployment, and in cases, even prolonged disability. This causes a significant economic burden on country.

     This review manuscript will review the latest in WAD approaches for interventional procedures. We base our review on relevant databases such as PubMed, Ovid-Medline, Embase, Web of Science, NIH website, Google Scholar, and the Cochrane Library. No Institutional Review Board permission was obtained since this manuscript does not directly involve animals or humans.

Keywords: Whiplash; whiplash-associated disorder; neck pain; chronic neck pain; motor vehicle collision; chronic pain syndrome; chronic pain; neck trauma

  1. Blincoe LJ., et al. The economic and societal impact of motor vehicle crashes, 2010. (Revised) (Report No. DOT HS 812 013). Washington, DC: National Highway Traffic Safety Administration (2015).
  2. Arizona Population (2022).
  3. Arizona Department of Transportation. 2021 Motor Vehicle Crash Facts for the State of Arizona. AZDOT.gov. (2022).
  4. Rashier A, Monk J and Gargan M. Whiplash: Synopsis of Causation UK Ministry of Defense (2008).
  5. Crowe HE. Injuries to the cervical spine. Paper presented at the meeting of the Western Orthopedic Association, San Francisco (1928).
  6. Severy DM, Matheysson JH and Bechtol JC. “Controlled automobiles rear-end collisions, an investigation of related engineering and mechanical phenomenon”. Can Serv Med J 11 (1955): 729-759.
  7. Wood H. “Anti-inflammatory drugs could cause chronic pain”. Nat Rev Neurol 18.7 (2022): 382.
  8. Jaeger B. “Myofascial trigger point pain”. Alpha Omegan 106.1-2 (2013): 14-22.
  9. Freeman MD, Nystrom A and Centeno C. “Chronic whiplash, and central sensitization; an evaluation of the role of a myofascial trigger point in pain modulation”. J Brachial Plex Peripher Nerve Inj 4 (2009): 2.
  10. Nystrom NA and Freeman MD. “Central Sensitization Is Modulated Following Trigger Point Anesthetization in Patients with Chronic Pain from Whiplash Trauma. A Double-Blind, Placebo-Controlled, Crossover Study”. Pain Med 19.1 (2018): 124-129.
  11. Byrn C., et al. “Subcutaneous sterile water injections for chronic neck and shoulder pain following whiplash injuries”. Lancet 341.8843 (1993): 449-52.
  12. Hurley RW., et al. “Consensus practice guidelines on interventions for cervical spine (facet) joint pain from a multispecialty international working group”. Regional Anesthesia & Pain Medicine 47.1 (2022): 3-59.
  13. Yang S and Chang MC. “The effectiveness of corticosteroid injection into cervical facet joint for managing whiplash-related neck pain”. Annals of Palliative Medicine 11.8 (2022): 2569-73.
  14. Kim KH., et al. “Cervical facet joint injections in the neck and shoulder pain”. Journal of Korean medical science 20.4 (2005): 659-62.
  15. Lee DW and Huston C. “Fluoroscopically-guided cervical zygapophyseal therapeutic joint injections may reduce the need for radiofrequency”. Pain Physician 21.6 (2018): E661-E665.
  16. Dydyk AM and Sekhri N. “Cervical Epidural Injection”. Treasure Island (FL): StatPearls Publishing (2022).
  17. Radhakrishnan K., et al. “Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990”. Brain 117.Pt 2 (1994): 325-35.
  18. Candido KD and Knezevic N. “Cervical epidural steroid injections for the treatment of cervical spinal (neck) pain”. Curr Pain Headaches Rep 17 (2013): 314.
  19. Manchikanti L., et al. “Two-year follow-up results of fluoroscopic cervical epidural injections in chronic axial or discogenic neck pain: a randomized, double-blind, controlled trial”. Int J Med Sci 11.4 (2014): 309-20.
  20. Sugawara T. “Anterior cervical spine surgery for degenerative disease: a review”. Neurologia medico-chirurgica 55.7 (2015): 540-6.
  21. Algers G., et al. “Surgery for chronic symptoms after whiplash injury”. Follow-up of 20 cases. Acta Orthop Scand 64.6 (1993): 654-6.
  22. Zhao T., et al. “Is Delayed Surgery After Unsuccessful Conservative Treatment Beneficial for Spinal Cord Injury Following Whiplash? A Retrospective Study in Elderly Patients”. Med Sci Monit 24 (2018): 2818-2824.