Classification of Trusted Related Conditions:
Fractures: Potential for cervical spine fractures following whiplash.
Low Back Pain: Common symptom following an injury.
Vestibular Injuries: Dizziness or balance issues may arise.
Tinnitus: Ringing in the ears, possibly linked to neck issues.
Basilar Artery Injury: Can cause vestibular symptoms, especially in children.
Subarachnoid Hemorrhage: Risk linked with carotid artery dissection (reference: Uhrenholt et al, 2015).
Retropharyngeal Abscess: Can result in serious complications like osteomyelitis and epidural abscess (reference: Goulart et al, 2016).
Fracture and Ligament Damage:
Description of injury vectors impacting the cervical spine, affecting the posterior and anterior longitudinal ligaments.
Kyphosis:
Acute kyphosis observed at C5-C6 due to whiplash injuries.
Potential tearing of interspinous and longitudinal ligaments noted.
Lumbopelvic Deceleration Syndrome:
Definition: Low back pain that follows whiplash injury as per Webb and Terrett (1985).
Literature focus on severe trauma cases but also includes joint and soft tissue injuries (16.5% - 40% reported incidence).
Five Mechanisms of Injury (Webb and Terrett, 1985):
Torsional Stress: Occurs in thoracolumbar region during vehicle restraints during an accident.
Lumbosacral Transitional Area Stress: High movement at L5 meets a relatively immobile sacrum causes injury.
Shear Stress at Lumbosacral Junction: Forces from immobilised ilia affecting the L5 segment.
Shear Stress at Sacroiliac Joint: Lumbar torsion causing displacement of the sacrum relative to the ilium.
Compression Force: Results in jamming at the sacroiliac joint, can produce endplate fractures.
Cervicogenic Somatic Tinnitus (CST):
Various causes: hearing loss or noise trauma; may relate to cervical spine sensory systems.
Useful diagnostic tests include:
Ear, nose, and throat exams.
Neck Bournemouth Questionnaire (NBQ).
Manual rotation tests, adapted Spurling test, and trigger point tests.
Positive tests can confirm CST.
Definition and Impact:
Tinnitus is an auditory sensation without an external source (defined by Kreuzer et al, 2012).
Trauma-associated tinnitus can result in greater psychological distress compared to other types of tinnitus.
Studies indicate that approximately 10% of whiplash patients may experience symptoms like tinnitus, vertigo, and deafness.
Literature review indicates a 14%-37.5% incidence of Temporo-mandibular Disorders (TMD) in whiplash populations (Fernandez et al, 2009).
Potential Mechanism:
Deceleration injury leads the mandible to move relative to the skull, causing potential injuries to various components of the TMJ.
Clinical Findings by Roydhouse:
Patients with whiplash commonly present symptoms of TMJ dysfunction following injury.
Clinical studies of 14 patients showed significant relief in symptoms post-TMJ treatment.
Suggestions from Roydhouse:
Damage to mandibular condyles (bone/cartilage) from displacement due to accident.
Neurological dysfunction of upper cervical nerves.
Alterations in posture affecting neck and jaw relationship.
Post-traumatic headaches may also be associated with TMJ complaints.
Posterior Movement of Skull: During whiplash, the mandible can be displaced anteriorly, leading to tension in related structures, resulting in TMJ dysfunction complaints.
Muscle Spasms and Postural Changes:
Myospasms can lead to improper jaw positioning, affecting joint coordination and resulting in pain.
Other influences include post-injury stress and altered posture which may exacerbate TMJ symptoms.
Anatomical Context: Illustrated the dynamic relationships between TMJ and surrounding anatomical structures, underscoring functional interrelations.