title: Cervical spine ligament injury during simulated frontal impact.
abstract: METHODS
  The supraspinous and interspinous ligaments, ligamentum flavum, and capsular and posterior longitudinal ligament strains were monitored during simulated frontal impact of whole cervical spine specimens with muscle force replication and compared with corresponding physiologic strain limits.
  
  
  OBJECTIVE
  To quantify the strains in the cervical spine ligaments during simulated frontal impact and investigate injury mechanisms.
  
  
  BACKGROUND
  Clinical and biomechanical studies have documented injuries to cervical spine ligaments during frontal impact. There are no biomechanical studies investigating subfailure injury mechanisms to these ligaments during simulated frontal impacts of increasing severity.
  
  
  METHODS
  The whole cervical spine with muscle force replication model and a bench-top sled were used to simulate frontal impacts at 4, 6, 8, and 10 g horizontal accelerations of the T1 vertebra. The peak ligament strains during frontal impacts were compared with physiologic strain limits determined during intact flexibility testing.
  
  
  RESULTS
  Significant increases (P < 0.05) in the supraspinous and interspinous ligaments and the ligamentum flavum strains beyond physiologic limits were observed throughout the cervical spine, with the highest strains occurring at C3-C4. Significant increases were observed in the capsular ligament strains only during the 10 g impact, whereas the posterior longitudinal ligament strains did not exceed physiologic limits.
  
  
  CONCLUSIONS
  The supraspinous and interspinous ligaments and the ligamentum flavum may be at risk for injury due to excessive strains during frontal impacts.
authors.affiliation: Biomechanics Research Laboratory, Department of Orthopedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut 06520-8071, USA. manohar.panjabi@yale.edu
authors.forename: Manohar M
authors.initials: MM
authors.lastname: Panjabi
authors.forename: Adam M
authors.initials: AM
authors.lastname: Pearson
authors.forename: Shigeki
authors.initials: S
authors.lastname: Ito
authors.forename: Paul C
authors.initials: PC
authors.lastname: Ivancic
authors.forename: S Elena
authors.initials: SE
authors.lastname: Gimenez
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tominaga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena / Q000295:instrumentation; D002574:Cervical Vertebrae / Q000293:injuries*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000293:injuries*; D017843:Ligamentum Flavum / Q000293:injuries; D017846:Longitudinal Ligaments / Q000293:injuries; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000209:etiology* / Q000473:pathology; D018583:Pliability; D012399:Rotation; D013314:Stress, Mechanical; D014949:Wounds, Nonpenetrating / Q000209:etiology* / Q000473:pathology