Traumatic Brain, Spine & Auto Injuries
Victims of car collisions must be carefully evaluated for injuries to the spine and supportive tissues, which include bones, joints, muscles, tendons, ligaments, intervertebral discs, cartilage, and nerves.
The most common ligamentous injuries to the spine are caused by car accidents. Ligaments are the ultimate structures to hold vertebrae together aligned. Ligaments not only help hold the spine together, but also prevent bones from moving too far apart from each other. The kinetic energy in a car collision generates 2.5 times greater G forces to the head and neck than the bumper of the car, at a mere 8.2mph!
It is the shear force that causes the tearing of the ligaments, tendons, muscles, joint capsules, and nerve sheaths. This injury is also known as “whiplash”. According to AMA Guidelines, ligamentous injuries causing 3.5mm or greater slippage is awarded 25 – 28% whole body impairment.
If it’s a rear-end collision, the car is jolted forward, and your body is jerked forward with it. Unfortunately, your head is not restrained, so it remains at the speed it was positioned before the impact. It is the translation along the horizontal plane, which generally occurs long before the head makes contact with the head restraint, that may be the single most important factor as regards to injury potential. This high shearing force damages facet joints, discs, ligaments, and joint capsules. If a ligament is stretched beyond its limit, it can become torn, and in many cases, it becomes lax because of the overstretching.
LIGAMENTS
Specialized Neck X-Rays are the best way to find Ligamentous Laxity
Ligamentous laxity is one of the most concerning injuries from a car collision. Because the injury can be permanent, and it doesn’t hurt. It is imperative that ligamentous laxity is ruled out days from the accident. A missed diagnosis of this injury can be detrimental. Unfortunately, the majority of clinics treating auto accident cases are not trained to find ligamentous laxity injuries, including Emergency Rooms.
There are 4 main ligaments that are typically injured in a crash:
- Anterior Longitudinal Ligament
- Posterior longitudinal ligament
- Alar Ligament accessory atlantoaxial
- Accessory Atlantoaxial (atlantodental ligament)
Think of ligaments like a plastic bag or plastic wrap. Plastic, if stretched, will not return to its normal shape again. Ligaments are the same way. Why this is so important is that when the ligament stretches too far, it becomes a permanent injury, since it will never have full strength or function the same way again.
Every whiplash injury must be graded, with grade 1 being the least severe and grade 5 being the most severe type of injury. When there is any ligamentous injury, treatment is going to take longer than a lesser grade of injury because the injury is more severe. Though every case is different, the typical treatment protocol for this type of injury is roughly 10-14 weeks of care. But depending on the amount of injury and risk factors, treatment can last many months, even up to a year.
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