[Chronic whiplash syndrome is no indication for craniocervical fixation].
Throughout many years, a large number of publications have focused on structural changes in soft tissues in the cervical spine in patients with whiplash associated disorders I-II. In recent years the development in MRI techniques have made it possible to visualize the small ligaments in the craniocervical junction; a small number of publications have investigated the association between signal changes in these ligaments and whiplash associated disorders I-II. The results are, however, not conclusive, and no prospective studies have demonstrated any causal connection between type of whiplash injury and signal changes in these ligaments. Craniocervical fixation is major surgery with a moderate level of perioperative complications. There is also a theoretical risk of increasing the degenerative process in the level below the fixation. The indications for craniocervical fixation are now serious conditions like instability caused by rheumatic arthritis, tumours and fractures. The scientific evidence for introducing a new indication for craniocervical fixation is lacking, and craniocervical fixation in WAD I-II must be considered experimental surgery.
Nygaard
Øystein P
ØP
Nasjonalt senter for spinale lidelser, St. Olavs Hospital, 7006 Trondheim. oystein.nygaard@ntnu.no
Kolstad
Frode
F
Kvistad
Kjell Arne
KA
Zwart
John Anker
JA
Solberg
Tore
T
Lied
Bjarne
B
Myrseth
Erling
E
Helseth
Eirik
E
Baardsen
Roald
R
D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D002908:Chronic Disease; D006801:Humans; D016268:Internal Fixators; D008279:Magnetic Resonance Imaging; D013123:Spinal Fusion / Q000295:instrumentation; D014911:Whiplash Injuries / Q000175:diagnosis / Q000601:surgery*