Recent studies have indicated that whiplash trauma does in fact initiate and accelerate degenerative changes of the cervical spine, spondylosis. This is an important factor to keep in mind when preparing your damage model for your clients. Nowadays, it seems that insurance companied second-guess all forms of treatment that is related to alleviating pain, and do not consider future medical care when making their initial offers of settlement. This study, and a long history of medical literature of the long-term effects of whiplash, now supports that degenerative change in a patient’s condition is caused as a result of whiplash.
Beginning in 1964, Ruth Jackson, MD published an article in the American Journal of Orthopedics titled “The Positive Findings in Neck Injuries”. Dr. Jackson’s findings in that article were based on her evaluation of 5,000 injured patients. Dr Jackson noted “[a]ny injury of the disc causes a disturbance in the dynamics of the motor unit of which the disc is a part. This leads to degeneration of the disc and the proximate joints.” This was one of the first medical studies of degeneration based upon an accelerating injury to the spine.
In 1989, the Cervical Spine Research Society produced a reference text which addressed the question of whiplash trauma and acceleration of the degenerative disc disease. The text showed that in one study, x-rays taken an average of seven years after whiplash injury evidenced neck disc arthritis was present in 39% of the patients studied. In the control group for the study, only 6% of the patients showed a neck disc arthritic condition. The study concluded “it appeared that the injury had started the slow process of disc degeneration.”
Continuing this trend, in 1993 a study was published pertaining to whiplash injury and surgical cervical disc pathology. The study was titled, “Whiplash injury and surgically treated cervical disc disease” and was published in the journal Injury. The study was a review of a previous whiplash injury in 215 patients who underwent an anterior cervical discectomy and fusion. The rate of the disc surgery was found to be twice that of a control group of 800 general orthopedic outpatients. The mean age at which the whiplash injury occurred in the surgical group was 37 years and in the control group 36 years. The mean age at operation of those patients with a previous whiplash injury was significantly less than those patients without previous whiplash injury. The study concluded, “[t]his study provides further evidence that whiplash injury causes structural changes predisposing [patients] to premature degenerative disc disease.”
Finally, in 1997 Drs. Gargan and Bannister published a long-term follow-up comparison of whiplash-injured patients to a group of matched controls. The study titled “The Comparative Effects of Whiplash Injuries” was published in the Journal of Orthopedic Medicine. This study is a cross-sectional age and sex-matched comparison of the clinical signs and radiographic features of 41 patients 10 years after whiplash injury, with 80 clinical and 100 radiographic controls. X-rays for the 41 patients who sustained a whiplash injury 10 years previously showed that radiographic degenerative changes in the cervical spine appeared 10 years earlier in the whiplash group than in the control group. The authors concluded that “[t]he prevalence of degenerative changes in the younger cervical spine [of the whiplash group] suggests that the condition has an organic basis … [a]fter soft tissue neck trauma, degenerative change presented over 4 times as frequently in those aged between 31 and 40 and twice as often between 41 and 50 … [d]egenerative change and its association with neck stiffness support an organic basis for the symptoms that follow soft tissue injuries of the neck.”
Therefore, when building up your damage model for your clients it is very important to consider the lasting effects of whiplash. I would like to thank The Chiropractic Impact Report for all of the helpful information.