Whiplash Injury of the Cervical Spine
Definition and scope
Whiplash injury is an acceleration–deceleration injury of the neck, usually produced by a sudden rear-end motor-vehicle impact, although it may also follow a side-impact collision, sports injury, fall, assault or other abrupt force. The head and trunk undergo rapid, unequal movement, causing transient hyperextension followed by flexion of the cervical spine. The term describes the mechanism of injury, whereas the clinical consequences range from transient neck pain and stiffness to demonstrable soft-tissue injury, cervical fracture, dislocation, neurological deficit or, rarely, spinal cord and vertebral artery injury.
In current clinical usage, symptoms after whiplash are commonly described as whiplash-associated disorders (WAD). A normal radiograph or computed tomography scan does not exclude clinically important muscular, ligamentous, facet-joint or disc-related injury. Conversely, persistent symptoms do not necessarily indicate structural instability; they may reflect altered neuromuscular control, pain sensitisation, psychological factors or associated vestibular and temporomandibular dysfunction. Thus, the diagnosis requires correlation of the mechanism, symptoms, examination and appropriate imaging.
Relevant anatomy and pathophysiology
The cervical spine consists of the mobile upper cervical complex, particularly the occiput–C1–C2 region, and the subaxial segments from C3 to C7. The cervical facet joints, intervertebral discs, anterior…