title: Case report: whiplash-associated disorder from a low-velocity bumper car collision: history, evaluation, and surgery.
abstract: METHODS
  Case report of a patient with a whiplash-associated disorder following a bumper car collision. Imaging studies failed to provide an anatomic explanation for the debilitating symptoms.
  
  
  OBJECTIVE
  To report a chronic, debilitating pain syndrome after a low-velocity bumper car collision while using complex range-of-motion data for the diagnosis, prognosis, and surgical indication in whiplash-associated disorder.
  
  
  BACKGROUND
  The controversy of whiplash-associated disorder mainly concerns pathophysiology and collision dynamics. Although many investigations attempt to define a universal lesion or determine a threshold of force that may cause permanent injury, no consensus has been reached.
  
  
  METHODS
  Eight years after a low-velocity collision, the patient underwent surgical excision of multiple painful trigger points in the posterior neck. Computerized motion analysis was used for pre- and postoperative evaluations.
  
  
  RESULTS
  Surgical treatment resulted in an increase in total active range of motion by 20%, reduced intake of pain medication, doubled the number of work hours, and generally led to a dramatic improvement in quality of life.
  
  
  CONCLUSIONS
  This case of whiplash-associated disorder after a low-velocity collision highlights the difficulty in defining threshold of injury in regard to velocity. It also illustrates the value of computerized motion analysis in confirming the diagnosis of whiplash-associated disorder and in the evaluation of prognosis and treatment.
authors.affiliation: Department of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Duffy
authors.forename: Wayne
authors.initials: W
authors.lastname: Stuberg
authors.forename: Stacey
authors.initials: S
authors.lastname: DeJong
authors.forename: Kurt V
authors.initials: KV
authors.lastname: Gold
authors.forename: N Ake
authors.initials: NA
authors.lastname: Nystrom
mesh_terms: D000059:Accidents; D000700:Analgesics / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006259:Craniocerebral Trauma / Q000209:etiology; D019299:Decompression, Surgical; D006970:Disorders of Excessive Somnolence / Q000209:etiology; D000071938:Fasciotomy; D019416:Head Movements; D006261:Headache / Q000209:etiology; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D009209:Myofascial Pain Syndromes; D009334:Neck Muscles / Q000601:surgery; D019547:Neck Pain / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D010292:Paresthesia / Q000209:etiology; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function; D011998:Recreation; D013710:Tendons / Q000601:surgery; D013997:Time Factors; D014911:Whiplash Injuries / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D014940:Work Schedule Tolerance; D014949:Wounds, Nonpenetrating / Q000209:etiology
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local