CERVICAL SPINE INJURIES IN FRONT, REAR AND SIDE IMPACTS

描述(改编自调查人员摘要)：大多数 颈椎是软组织损伤，由于低能量的撞击 追尾事故。软组织受伤的事故受害者已经被 已知在事故发生后多年仍有残余疼痛。不那么频繁， 但更严重的是由于正面和侧面碰撞造成的颈部受伤。这个 拟议研究的总体目标是为了更好地了解 这些伤痕。 现有的研究使用了志愿者，完整的身体， 人体测量假人，以及模拟造成伤害的数学模型 事件。这些实验中的创伤事件是从外部和 不是在颈椎受伤的地方。建议的独特之处 研究在于它有能力在手术过程中直接研究损伤部位 精神创伤。新鲜的人类颈椎标本(枕骨至T1)将 被利用了。标本被提供了适当的头部代理。这个 试件在整体模拟压缩弹簧的帮助下稳定 肌肉功能。创伤是在特殊构造的设备中产生的 其中，试件底部的加速度，即T1椎体，是 模拟的与现实生活中的车祸记录相似。 拍摄X光片，测量多维不稳定性之前和 就在创伤之后。在创伤期间，枕骨和T1的负荷， 头部的加速度、椎间的运动和关节的变形 连续测量韧带和椎动脉。创伤后，CT检查 进行扫描和核磁共振检查，并对标本进行解剖，损伤部位 对软组织和骨骼进行描述和量化。调查人员 建议研究四种创伤：头朝前和头向后撞 到侧面，正面和侧面撞击。损伤阈值和损伤机制 对于低能量和中等能量的创伤将被确定。 研究的意义在于帮助人们更好地了解 低能量和中等能量损伤对颈椎的作用机制。 通过设计可在预防这些损伤方面取得重大进展 最佳的汽车座椅和安全设备；通过开发 对软组织损伤更敏感的放射检查；以及 更好地评估解剖损伤和多方位治疗 不稳定因素。

DESCRIPTION (adapted from the Investigator's abstract): Most injuries of the cervical spine are soft tissue injuries, due to low-energy impacts from rear-end collisions. The accident victims with soft tissue injuries have been known to have residual pain for many years after the accident. Less frequent, but more severe are neck injuries due to frontal and side collisions. The overall objective of the proposed research is to provide a better understanding of these injuries. The available research studies have used volunteers, whole cadavers, anthropometric dummies, and mathematical models to simulate the injury-causing events. The traumatic event in these experiments is studied from outside and not at the site of injury in the cervical spine. The uniqueness of the proposed research lies in its ability to directly study the site of injury during the trauma. Fresh cadaveric human cervical spine specimens (occiput to T1) will be utilized. The specimen is provided with an appropriate head surrogate. The specimen is stabilized with the help of compression springs simulating overall muscle function. The trauma is produced in a specially constructed apparatus where the acceleration at the base of the specimen, i.e. the T1 vertebra, is simulated to be similar to that documented in real life car crashes. Radiographs are taken, and multidimensional instability is measured before and immediately after the traumas. During the trauma, loads at occiput and T1, accelerations of the head, intervertebral motions, and deformations of the ligaments and vertebral artery are continuously measured. After the trauma, CT scan and MRI are performed, and the specimen is dissected and the injuries to the soft tissues and bones are described and quantified. The investigators propose to study four traumas: rear-impacts with head-forward and head-turned to side, and frontal and side impacts. Injury thresholds and injury mechanisms for low and moderate energy traumas will be determined. The significance of the research lies in helping provide better understanding of the mechanisms of low-and moderate energy traumas to the cervical spine. Significant advances can be made in prevention of these injuries by designing optimal automotive seats and safety equipment; in diagnosis by developing radiographic tests that are more sensitive to soft tissue injuries; and, in treatment by better assessment of the anatomic injuries and multidirectional instabilities.