Intervertebral Neck Injury Criterion (IV-NIC) is based on the hypothesis that dynamic three-dimensional intervertebral motion beyond physiological limits may cause multiplanar injury of cervical spine soft tissues. Goals of this study, using a biofidelic whole human cervical spine model with muscle force replication and surrogate head in simulated side impacts, were to correlate IV-NIC with multiplanar injury and determine IV-NIC injury threshold for each intervertebral level. Using a bench-top apparatus, side impacts were simulated at 3.5, 5, 6.5, and 8 g horizontal accelerations of the T1 vertebra. Pre- and post-impact flexibility testing in three-motion planes measured the soft tissue injury, i.e., significant increase (p less than 0.05) in neutral zone (NZ) or range of motion (RoM) at any intervertebral level, above corresponding physiological limit. IV-NIC in left lateral bending correlated well with total lateral bending RoM (R = 0.61, P less than 0.001) and NZ (R = 0.55, P less than 0.001). Additionally, the same IV-NIC correlated well with left axial rotation RoM (R = 0.50, P less than 0.001). IV-NIC injury thresholds (95% confidence limits) varied among intervertebral levels and ranged between 1.5 (0.6-2.4) at C3-C4 and 4.0 (2.4-5.7) at C7-T1. IV-NIC injury threshold times were attained beginning at 84.5 ms following impact. Present results suggest that IV-NIC is an effective tool for determining multiplanar soft tissue neck injuries by identifying the intervertebral level, mode, time, and severity of injury. (Author/publisher).
Samenvatting