Cervical spine whiplash injury

The most common type of injury due to combined tension and extension of the cervical spine is the whiplash syndrome. However, a large majority of such injuries involve the soft tissues of the neck, and the pain is believed to reside in the joint capsules of the articular facets of the cervical vertebrae [Wallis et al., 1997]. In severe cases, teardrop fractures of the anterosuperior aspect of the vertebral body can occur. Alternately, separation of the anterior aspect of the disk from the vertebral endplate is known to occur. More severe injuries occur when the chin impacts the instrument panel or when the forehead impacts the windshield. In both cases, the head rotates rearward and applies a tensile and bending load on the neck. In the case of windshield impact by the forehead, hangman s fracture of C2 can occur. Garfin and Rothman [1983] suggested that it is caused by spinal extension combined with compression on the lamina of C2, causing the pars to fracture. 

The cervical spine is frequently involved in trauma caused by the flexibility of the neck with a heavy head sitting atop the small vertebrae. With the rapid motion of modern vehicles, ac-celeration/deceleration injuries of the neck are quite common. As the neck is snapped forward and backward, the long muscles tend to have their fibers torn, with associated bleeding into the muscles. However, it is important to remember that "whiplash injury" is not a problem of the cervical spine alone, because the entire body has abnormal forces applied to it. Osteopathic manipulation is a major part of the treatment of the patient with whiplash injuries. 

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