Welcome to CDC Stacks | The role of tissue damage in whiplash associated disorders: Discussion paper 1 - 33288 | CDC Public Access
Stacks Logo
Advanced Search
Select up to three search categories and corresponding keywords using the fields to the right. Refer to the Help section for more detailed instructions.
 
 
Help
Clear All Simple Search
Advanced Search
The role of tissue damage in whiplash associated disorders: Discussion paper 1
Filetype[PDF - 299.27 KB]


Details:
  • Pubmed ID:
    22020601
  • Pubmed Central ID:
    PMC3248632
  • Funding:
    5R01CE001257/CE/NCIPC CDC HHS/United States
    AR056288/AR/NIAMS NIH HHS/United States
    AR056328/AR/NIAMS NIH HHS/United States
    R01 AR056328/AR/NIAMS NIH HHS/United States
    R01 AR056328-01A1/AR/NIAMS NIH HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    STUDY DESIGN

    Non-systematic review of cervical spine lesions in whiplash-associated disorders (WAD).

    OBJECTIVE

    To describe whiplash injury models in terms of basic and clinical science, to summarize what can and cannot be explained by injury models, and to highlight future research areas to better understand the role of tissue damage in WAD.

    SUMMARY OF BACKGROUND DATA

    The frequent lack of detectable tissue damage has raised questions about whether tissue damage is necessary for WAD and what role it plays in the clinical context of WAD.

    METHODS

    Non-systematic review.

    RESULTS

    Lesions of various tissues have been documented by numerous investigations conducted in animals, cadavers, healthy volunteers and patients. Most lesions are undetected by imaging techniques. For zygapophysial (facet) joints, lesions have been predicted by bioengineering studies and validated through animal studies; for zygapophysial joint pain, a valid diagnostic test and a proven treatment are available. Lesions of dorsal root ganglia, discs, ligaments, muscles and vertebral artery have been documented in biomechanical and autopsy studies, but no valid diagnostic test is available to assess their clinical relevance. The proportion of WAD patients in whom a persistent lesion is the major determinant of ongoing symptoms is unknown. Psychosocial factors, stress reactions and generalized hyperalgesia have also been shown to predict WAD outcomes.

    CONCLUSION

    There is evidence supporting a lesion-based model in WAD. Lack of macroscopically identifiable tissue damage does not rule out the presence of painful lesions. The best available evidence concerns zygapophysial joint pain. The clinical relevance of other lesions needs to be addressed by future research.