Münker H, Langwieder K, Chen E, Hell W
Orthopädischen Universitätsklinik Friedrichsheim, Frankfurt am Main.
Versicherungsmedizin. 1995 Feb 1;47(1):26-32.
Despite the improvement of protective properties in vehicles acceleration injuries to the cervical spine have not lost their significance. The increase of minor injuries and a high rate of seat belt usage is, beside other reasons, responsible for the increase of mild cervical spine injuries. From a data pool of 15,000 vehicle-vehicle collisions the portion of cervical spine injuries was selected for further investigation. Acceleration injuries to the cervical spine occur especially during rear end collisions. It can be shown that women, front seat occupants and occupants of lighter vehicles have a higher risk of suffering from such injuries. More than 90% of cervical spine injured had mild injuries by AIS standards; the portion of injuries with fractures was 0.6%. The diagnosis "wiplash injury" or "acceleration injury to the cervical spine" was given in more than 30% of all cervical spine injured showing only 1 symptom. Although most patients are first being treated in a hospital only 2/3 from 744 detailed studied cases were x-rayed, which in 71% were without significant conditions. Additional instrumental diagnostic measures (CT, MR) were used in only 1%. The study indicates that the "acceleration injury" requires a critical verification by doctors and insurers. A detailed finding following a thorough history taking and, in case, an interdisciplinary definition of accident injuries an early point of time will certain the diagnosis and facilitate therapy and judgement.
尽管车辆防护性能有所提升，但颈椎加速损伤仍未失去其重要性。除其他原因外，轻伤的增加以及安全带的高使用率是轻度颈椎损伤增加的原因。从15000起车辆碰撞事故的数据池中选取了颈椎损伤部分进行进一步调查。颈椎加速损伤尤其发生在追尾碰撞期间。可以看出，女性、前排乘客和轻型车辆的乘客遭受此类损伤的风险更高。按照AIS标准，超过90%的颈椎损伤为轻伤；骨折损伤的比例为0.6%。在所有颈椎损伤中，超过30%仅表现出1种症状的患者被诊断为“挥鞭样损伤”或“颈椎加速损伤”。虽然大多数患者首先在医院接受治疗，但在744例详细研究的病例中，只有2/3进行了X光检查，其中71%没有明显病症。仅1%的患者使用了额外的仪器诊断措施（CT、MR）。该研究表明，“加速损伤”需要医生和保险公司进行严格核查。通过全面的病史采集得出详细结果，并在必要时对事故损伤进行多学科界定，尽早确定诊断将有助于治疗和判断。
