A Publication of WTVP

The April 22, 2005, Journal of Neurotrauma talked about whiplash associated disorders (WAD) impairment rating and neck disability scoring based upon the severity of MRI findings of membrane and ligaments in the upper cervical spine. The aim of this study was to explore whether reported pain and functional disability in WAD patients is associated with lesions to specific soft tissue structures in the upper cervical spine, as assessed by MRI.

Pre-selected structures for MRI assessment included the alar ligaments, the transverse ligament, the tectorial, and the posterior atlanto-occipital membranes. These ligaments are taken from the Latin prefix “alar,” which means wings and are in the top two segments of the cervical spine. There were 92 whiplash test patients and 30 control subjects. The WAD patients reported significantly more pain and disabilities. Upon examination, the WAD patients also had MRI lesions to the alar ligaments and showed the most consistent form of pain and disability.

The neck disability index (NDI) stated that the results from this study indicate symptoms and complaints among WAD patients can be limited with structural abnormalities in ligaments and membranes of the upper cervical spine. This grading of ligaments was done using the increased signal of an MRI. Crash victims are at twice the risk from similar traumas other than crash traumas. The conclusion of these studies is that pain most often produced after whiplash is the result of ligament damage, mainly alar and transverse ligaments. The membrane surrounding the brain stem isn’t believed to be the source of most pain. Overall, females have been shown to have a 30 percent increased injury rate, compared to males at the same impact force. Females also have more multiple lesions.

As a chiropractor, these study results are very significant in treatment of ligamentous weakness versus membrane swelling when recognizing the source of pain. The bottom line goal is healing through chiropractic adjustments, associated therapies, and rehabilitation to establish the importance and integrity of vertebral mobility. Ligaments once traumatized and weak don’t respond well to most care; however, there will be absolutely no response if treatment is never applied.

What’s most irritating are the opinions of some insurance companies when considering treatment for a patient. The sooner care is rendered after an onset, the better the rate of recovery will be. IBI