title: Incremental and single trauma produce equivalent subfailure soft tissue injury of the cervical spine.
abstract: BACKGROUND
  Automotive collision simulations have been performed using either incremental or single trauma. In single trauma, a single impact is performed, while in incremental trauma, a series of impacts of increasing severity are executed. Equivalency of incremental and single trauma for soft tissue injury severity due to the final impact has not been established. Thus, the purpose of the present study was to investigate whether incremental and single trauma produced similar cervical spine subfailure injury severity due to simulated frontal impacts.
  
  
  METHODS
  Porcine cervical spine specimens (C2-T1) of the incremental trauma group were subjected to five frontal impacts (2, 3.5, 5, 6.5, 8 g), while single trauma specimens were subjected to a single impact (8 g). Flexibility tests were performed on specimens while intact and following each impact. Intact and post 8 g flexibility parameters were compared within incremental and single trauma groups and between groups.
  
  
  RESULTS
  No significant differences (P < 0.05) were found between incremental and single trauma groups when either intact or post 8 g flexibility parameters were compared. Significant increases in flexibility parameters from intact to post 8 g were observed in both groups, indicating soft tissue injury.
  
  
  CONCLUSIONS
  Incremental and single trauma produced equivalent subfailure cervical spine injury in simulated impacts, for the experimental conditions studied. This study may facilitate greater use of the incremental trauma protocol in future experimental designs.
authors.affiliation: Biomechanics Research Laboratory, Department of Orthopedics and Rehabilitation, Yale University School of Medicine, 333 Cedar St., P.O. Box 208071, New Haven, CT 06520-8071, USA.
authors.forename: Saif A
authors.initials: SA
authors.lastname: Ghole
authors.forename: Paul C
authors.initials: PC
authors.lastname: Ivancic
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tominaga
authors.forename: S Elena
authors.initials: SE
authors.lastname: Gimenez
authors.forename: Manohar M
authors.initials: MM
authors.lastname: Panjabi
mesh_terms: D000063:Accidents, Traffic; D000818:Animals; D002574:Cervical Vertebrae / Q000293:injuries* / Q000503:physiopathology*; D003238:Connective Tissue / Q000293:injuries* / Q000503:physiopathology*; D004195:Disease Models, Animal; D004548:Elasticity; D066298:In Vitro Techniques; D012720:Severity of Illness Index; D013552:Swine; D014911:Whiplash Injuries / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*