title: Re-evaluating the neck injury index (NII) using experimental PMHS tests.
abstract: OBJECTIVE
  The neck injury index, NII, developed in ISO 13232 (2005) as a testing and evaluation procedure for assessing the risk of injury to the AO/C1/C2 region of the cervical spine in motorcycle riders is reevaluated using an existing postmortem human subjects (PMHS) data set and resulting in a reformulated NII criterion applicable to PMHS tests.
  
  
  METHODS
  A recent series of 36 PMHS head/neck component tests was used to examine the risk of neck injury in frontal impacts and to assess the predictive capability of NII for impacts of various orientations. Using force and moment load cell PMHS experimental data, injury risk was assessed using NII evaluated with the ISO 13232-5 algorithms.
  
  
  RESULTS
  The injury risk predictions are compared with the injury outcomes from the head/neck PMHS. The NII criterion underestimated the injury incidence of the PMHS experimental group. The average predicted risk of injuries for the experimental injury tests based on NII across the MAIS levels was 0.7 percent, though there were 11 AIS 3+ injuries observed in the actual testing (30.6%). Using the experimental injury outcomes and the experimental force and moment time histories, the normalizing coefficients from NII are reevaluated to minimize the difference between NII risk assessment and the experimental injury outcome in the least squares (L(2)) basis. This reanalysis is compared with existing human and PMHS neck injury criteria.
  
  
  CONCLUSIONS
  By reanalyzing the NII formulation using an existing PMHS injury data set with known forces and moments and known injury outcomes, a new NII(PMHS) is developed that uses PMHS loads to predict injury. This reformulation removes the dependency of the original NII formulation on the forces and moments from motorcyclist anthropomorphic test device (MATD) experiments and simulations yet retains the advantages of the multi-axial neck injury criterion.
authors.affiliation: Biomedical Engineering Department, Duke University, Durham, North Carolina, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Bass
authors.forename: R S
authors.initials: RS
authors.lastname: Salzar
authors.forename: S R
authors.initials: SR
authors.lastname: Lucas
authors.forename: K A
authors.initials: KA
authors.lastname: Rafaels
authors.forename: A M
authors.initials: AM
authors.lastname: Damon
authors.forename: J R
authors.initials: JR
authors.lastname: Crandall
mesh_terms: D000063:Accidents, Traffic; D000465:Algorithms; D002574:Cervical Vertebrae / Q000293:injuries*; D006801:Humans; D016018:Least-Squares Analysis; D009049:Motorcycles; D019838:Neck Injuries; D016011:Normal Distribution; D018570:Risk Assessment / Q000379:methods*; D016019:Survival Analysis; D015599:Trauma Severity Indices