title: Increased sagittal plane segmental motion in the lower cervical spine in women with chronic whiplash-associated disorders, grades I-II: a case-control study using a new measurement protocol.
abstract: METHODS
  Case-control study comparing sagittal plane segmental motion in women (n = 34) with chronic whiplash-associated disorders, Grades I-II, with women (n = 35) with chronic insidious onset neck pain and with a normal database of sagittal plane rotational and translational motion.
  
  
  OBJECTIVE
  To reveal whether women with chronic whiplash-associated disorders, Grades I-II, demonstrate evidence of abnormal segmental motions in the cervical spine.
  
  
  BACKGROUND
  It is hypothesized that unphysiological spinal motion experienced during an automobile accident may result in a persistent disturbance of segmental motion. It is not known whether patients with chronic whiplash-associated disorders differ from patients with chronic insidious onset neck pain with respect to segmental mobility.
  
  
  METHODS
  Lateral radiographic views were taken in assisted maximal flexion and extension. A new measurement protocol determined rotational and translational motions of segments C3-C4 and C5-C6 with high precision. Segmental motion was compared with normal data as well as among groups.
  
  
  RESULTS
  In the whiplash-associated disorders group, the C3-C4 and C4-C5 segments showed significantly increased rotational motions. Translational motions within each segment revealed a significant deviation from normal at the C3-C4 segment in the whiplash-associated disorders and insidious onset neck pain groups and at the C5-C6 segment in the whiplash-associated disorders group. Significantly more women in the whiplash-associated disorders group (35.3%) had abnormal increased segmental motions compared to the insidious onset neck pain group (8.6%) when both the rotational and the translational parameters were analyzed. When the translational parameter was analyzed separately, no significant difference was found between groups, or 17.6% (whiplash-associated disorders group) and 8.6% (insidious onset neck pain group), respectively.
  
  
  CONCLUSIONS
  Hypermobility in the lower cervical spine segments in 12 out of 34 patients with chronic whiplash-associated disorders in this study point to injury caused by the accident. This subgroup, identified by the new radiographic protocol, might need a specific therapeutic intervention.
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavík, Iceland. eythork@simnet.is
authors.forename: Eythor
authors.initials: E
authors.lastname: Kristjansson
authors.forename: Gunnar
authors.initials: G
authors.lastname: Leivseth
authors.forename: Paul
authors.initials: P
authors.lastname: Brinckmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Frobin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D002908:Chronic Disease; D005260:Female; D006801:Humans; D009068:Movement; D011859:Radiography / Q000379:methods; D014911:Whiplash Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging*