Biomechanical assessment of soft tissue neck injuries in cases with long sick leave times

A database was established by collecting 919 cases of claimed cervical spine disorders (CSDs) sustained in automotive accidents. All cases had a sick leave time of more than 4 weeks. Data was obtained from a major Swiss accident insurer. An assessment scheme was developed that took into account technical, medical, and biomechanical aspects. All cases were evaluated according to this scheme. The overall biomechanical assessment, that stated the extent to which the symptoms claimed could be explained by the impact, was found to be significantly influenced by the patient's history of CSD in terms of preexisting damage or preexisting symptoms. In 52% of the assessed cases, the CSD claimed could be explained with a combination of neck loading and also by considering the patient's medical history. Performing a solely technical analysis of the collision circumstances or a purely medical evaluation based on a Quebec Task Force (QTF) grade alone are insufficient to assess the accident-related explicability of claimed CSD. Biomechanically relevant individual factors have to be considered.