[Injuries to the cervical spine in automobile accidents]

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.