Loughborough University, Loughborough, UK.
Sprout Osteopathy, South Fremantle, Australia.
Eur Spine J. 2021 Oct;30(10):3043-3058. doi: 10.1007/s00586-021-06851-y. Epub 2021 May 11.
We present a unique opportunity to compare standard neck injury criteria (used by the automotive industry to predict injury) with real-life injuries. The injuries sustained during, and the overall kinematics of, a television demonstration of whiplash mechanics were used to inform and validate a vertebral level model of neck mechanics to examine the relevance of current injury criteria used by the automotive industry.
Frontal and rear impact pulses, obtained from videos of sled motion, were used to drive a MADYMO human model to generate detailed segmental level biomechanics. The maximum amplitude of the frontal and rear crash pulses was 166 ms and 196 ms, respectively, both with a duration of 0.137 s. The MADYMO model was used to predict standard automotive neck injury criteria as well as detailed mechanics of each cervical segment.
Whilst the subject suffered significant upper neck injuries, these were not predicted by conventional upper neck injury criteria (Nij and Nkm). However, the model did predict anterior accelerations of C1 and C2 of 40 g, which is 5 times higher than the threshold of the acceleration for alar ligament injury. Similarly, excessive anterior shear displacement (15 mm) of the skull relative to C2 was predicted. Predictions of NIC, an injury criterion relevant to the lower neck, as well as maximum flexion angles for the lower cervical segments (C3-T1) exceeded injury thresholds.
The criteria used by the automotive industry as standard surrogates for upper neck injury (Nij and Nkm) did not predict the significant cranio-cervical junction injury observed clinically.
我们提供了一个独特的机会，可以将标准颈部损伤标准（汽车行业用于预测损伤的标准）与实际损伤进行比较。利用在电视演示中观察到的挥鞭伤力学中的损伤以及整体运动学来为颈部力学的椎体水平模型提供信息并进行验证，以研究汽车行业目前使用的损伤标准的相关性。
使用从 sled 运动视频中获得的正面和背面冲击脉冲来驱动 MADYMO 人体模型，以生成详细的节段水平生物力学。正面和背面碰撞脉冲的最大幅度分别为 166ms 和 196ms，持续时间均为 0.137s。MADYMO 模型用于预测标准汽车颈部损伤标准以及每个颈椎段的详细力学。
尽管受试者遭受了严重的上颈部损伤，但这些损伤并未被常规的上颈部损伤标准（Nij 和 Nkm）预测。然而，该模型确实预测了 C1 和 C2 的前向加速度为 40g，这是翼状韧带损伤加速度阈值的 5 倍。同样，预测了颅骨相对于 C2 的过度前向剪切位移（15mm）。还预测了与下颈部相关的损伤标准 NIC 以及下颈椎段（C3-T1）的最大屈曲角度超过了损伤阈值。
汽车行业作为上颈部损伤标准替代品使用的标准（Nij 和 Nkm）并未预测到临床上观察到的严重颅颈连接损伤。
