1999•UWA Profiles and Research Repository (University of Western Australia)Requires access
PATTERNS OF INJURY TO THE CERVICAL SPINE RELATED TO THE DIRECTION AND MAGNITUDE OF IMPACT TO THE HEAD
G A Ryan, A. R. Moore, John A.M. Taylor
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Abstract
The objective of this project was to determine, for fatally injured car and truck occupants, if there were patterns of injury to the cervical spine, which could be related to the direction, and magnitude of the impact to the head. A detailed examination of the cervical spine was carried out in 43 cases. The spine was removed at post mortem examination, frozen and cut into sections, each 2 mm thick, in the sagittal plane. Each section was examined microscopically and the injuries recorded. For each case, the Coroner’s records were examined and the events of the crash re-constructed from the available evidence to determine the direction and point of impact on the head, if any, and magnitude of the impact, if possible. Sufficient information was available in 29 cases. Impact velocity ranged from about 10 km/h to 70 km/h. There were 10 impacts to the front of the head, five impacts to the top, 13 impacts to the side of the head (eight left, five right), and one to the rear. The presence or absence of injury was recorded at thirty possible location of injury along the cervical spine between the occipito-cervical joint and the C7-T1 intervertebral disc. Impacts to the top of the head tended to produce more widespread injury, compared with front and lateral impacts, given impacts of similar magnitude. Impacts to the top of the head produced an injury distribution that was symmetrical laterally with a concentration in the lower part of the cervical spine and with a relatively high ratio of bony injury to disc injury. For frontal impacts the injuries to the spine were also symmetrical about the midline, but with a concentration at the upper and lower levels, and in the intervertebral disc structures. For left lateral impacts to the head, injuries appeared symmetrical on both sides of the spine, but there was a concentration of injury in the upper region of the spine more than at the lower. Compared with the frontal and top impacts, there were fewer injuries to the intervertebral discs and the cervical bodies.