Aljinović Jure, Barišić Igor, Poljičanin Ana, Kuzmičić Sandra, Vukojević Katarina, Gugić Bokun Dijana, Vlak Tonko
Institute of Physical and Rehabilitation Medicine with Rheumatology, University Hospital of Split, Šoltanska 1, 21000, Split, Croatia.
Department of Health Studies, University of Split, Split, Croatia.
Wien Klin Wochenschr. 2020 Sep;132(17-18):506-514. doi: 10.1007/s00508-020-01631-y. Epub 2020 Mar 18.
Whiplash injury of the cervical spine is the most common injury after a car accident and in 25% of patients it progresses into chronic neck pain.
To investigate the difference in neck muscle stiffness using shear wave ultrasound elastography between subjects who suffered an uncomplicated whiplash injury and a control group. Possible recognition of patients who insist on physical therapy in order to support their false whiplash injury claims.
This study included 75 whiplash injury patients and 75 control subjects. Trapezius, splenius capitis and sternocleidomastoid muscles were examined by ultrasound shear wave elastography.
Increased muscle stiffness was noticed in trapezius muscle bilaterally in the whiplash group when compared to the control group (p < 0.001; right 57.47 ± 13.82 kPa vs. 87.84 ± 23.23 kPa; left 54.4 ± 12.68 kPa vs. 87.21 ± 26.47 kPa). Muscle stiffness in splenius capitis and sternocleidomastoid muscles was not suitable for analysis because of asymmetrical data distribution. Patients with less than 76 kPa of muscle stiffness in trapezius muscle are unlikely to belong in whiplash injury group (sensitivity 90% for right and 97% for left trapezius muscle, specificity 72% and 73%, respectively).
Patients measuring below 76 kPa of muscle stiffness in the trapezius muscle might have no whiplash injury. Further follow-up of the patients measuring higher than cut-off value might be beneficial for detecting patients with prolonged neck muscle spasm that can lead to chronic cervical pain syndrome.
颈椎挥鞭样损伤是车祸后最常见的损伤，25%的患者会发展为慢性颈部疼痛。
利用剪切波超声弹性成像技术，研究单纯性挥鞭样损伤患者与对照组之间颈部肌肉僵硬度的差异。识别可能坚持进行物理治疗以支持其虚假挥鞭样损伤索赔的患者。
本研究纳入75例挥鞭样损伤患者和75例对照者。采用超声剪切波弹性成像技术检查斜方肌、头夹肌和胸锁乳突肌。
与对照组相比，挥鞭样损伤组双侧斜方肌的肌肉僵硬度增加（p<0.001；右侧57.47±13.82kPa对87.84±23.23kPa；左侧54.4±12.68kPa对87.21±26.47kPa）。由于数据分布不对称，头夹肌和胸锁乳突肌的肌肉僵硬度不适于分析。斜方肌肌肉僵硬度低于76kPa的患者不太可能属于挥鞭样损伤组（右侧斜方肌敏感性为90%，左侧为97%，特异性分别为72%和73%）。
斜方肌肌肉僵硬度测量值低于76kPa的患者可能没有挥鞭样损伤。对测量值高于临界值的患者进行进一步随访，可能有助于发现颈部肌肉长期痉挛并可能导致慢性颈痛综合征的患者。
