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Is Preexisting Cervical Degeneration a Risk Factor for Poor Prognosis in Whiplash-Associated Disorder?
Khalid Malik1, K C Eseonu2, D Pang3
1Speciality Registrar, Trauma and Orthopaedics, Guy's & St. Thomas' Hospitals, London, United Kingdom.
International Journal of Spine Surgery
|July 20, 2021
Summary
Preexisting facet joint degeneration, but not disc degeneration, predicts poor prognosis in whiplash-associated disorders (WAD). Moderate evidence suggests facet joint issues contribute to long-term WAD symptoms.
Area of Science:
- Orthopedics
- Neurology
- Biomedical Engineering
Background:
- Whiplash-associated disorders (WAD) result from cervical spine acceleration-deceleration injuries.
- While often self-limiting, some WAD cases lead to persistent symptoms.
- Cervical spine degeneration's role in WAD prognosis requires clarification.
Purpose of the Study:
- To review literature on the predictive value of cervical degeneration in WAD prognosis.
- To identify specific degenerative changes associated with long-term WAD symptoms.
Main Methods:
- Comprehensive literature search conducted.
- Nine studies involving 894 patients (aged 16-76) were included.
- Analysis focused on associations between cervical degeneration and WAD recovery.
Main Results:
- Moderate facet joint degeneration significantly correlated with nonrecovery.
- No association found between isolated disc degeneration and nonrecovery.
- Total cervical degeneration (facet + disc) correlated with nonrecovery; preexisting degeneration linked to poorer prognosis.
Conclusions:
- Preexisting facet joint degeneration is a negative prognostic indicator for WAD.
- Disc degeneration does not appear to influence WAD chronicity.
- Facet joint instability may underlie persistent WAD symptoms; further research is needed.
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