Wyrwich W, Heyde C E
Zentrum für spezielle Chirurgie des Bewegungsapparates, Klinik für Unfall- und Wiederherstellungschirurgie, Campus Benjamin Franklin, Charité, Universitätsmedizin, Berlin.
Orthopade. 2006 Mar;35(3):319-30. doi: 10.1007/s00132-005-0917-3.
Reasons for problems in stating an expert opinion on acceleration injuries of the cervical spine are numerous. The presence of unexpected or the absence of expected symptoms, the lack of objective proof for alterations or the presence of complaints that are difficult to prove, the discrepancy between recognizable force of the impact versus the resulting damage to the injured as well as the chance of being completely incapable of rendering proof that unquestionably a potentially damage-causing event is--beyond any reasonable doubt--the origin of an observed alteration in an injured individual are some of the problems a medical expert has to face when dealing with the analysis of injuries of the cervical spine. Unsatisfactory documentation in the patient's records, discussions about the reliability of diagnostic means or the interpretation of their results, difficult to procure evidence of accident-specific biomechanics and their direct or indirect impact on the body or neck of the injured person as well as distinguishing cervical sprain from mild brain damage, post-traumatic distress syndrome, cognitive disorder, psychiatric disease, aggravation, or malingering makes it hard for an expert to state an expert opinion.
就颈椎加速损伤发表专家意见时存在诸多问题。存在意外症状或缺乏预期症状、缺乏改变的客观证据或存在难以证实的主诉、可识别的撞击力与受伤者所受损伤之间的差异，以及完全无法毫无疑问地证明一个潜在的致伤事件——排除任何合理怀疑——是受伤个体所观察到的改变的根源，这些都是医学专家在分析颈椎损伤时必须面对的一些问题。患者记录中的记录不充分、关于诊断手段可靠性或其结果解释的讨论、难以获取特定事故生物力学及其对受伤者身体或颈部的直接或间接影响的证据，以及区分颈椎扭伤与轻度脑损伤、创伤后应激综合征、认知障碍、精神疾病、病情加重或诈病，都使得专家难以发表专家意见。
