Stemper BD, et al.
J Biomech. 2005 Jun;38(6):1313-23.
Abstract
Although considerable biomechanical investigations have been conducted to understand the response of the cervical spine under whiplash (rear impact-induced postero-anterior loading to the thorax), studies delineating the effects of initial spinal curvature are limited. This study advanced the hypothesis that abnormal curvatures (straight or kyphotic) of the cervical column affect spinal kinematics during whiplash loading. Specifically, compared to the normal lordotic curvature, abnormal curvatures altered facet joint ligament elongations. The quantifications of these elongations were accomplished using a validated mathematical model of the human head-neck complex that simulated three curvatures. The model was validated using companion experiments conducted in our laboratory that provided facet joint kinematics as a function of cervical spinal level. Regional facet joint ligament elongations were investigated as a function of whiplash loading in the four local anatomic regions of each joint. Under the normal posture, greatest elongations occurred in the dorsal anatomic region at the C2-C3 level and in the lateral anatomic region from C3-C4 to C6-C7 levels. Abnormal postures increased elongation magnitudes in these regions by up to 70%. Excessive ligament elongations induce laxity to the facet joint, particularly at the local regions of the anatomy in the abnormal kyphotic posture. Increased laxity may predispose the cervical spine to accelerated degenerative changes over time and lead to instability. Results from the present study, while providing quantified level- and region-specific kinematic data, concur with clinical findings that abnormal spinal curvatures enhance the likelihood of whiplash injury and may have long-term clinical and biomechanical implications.