There are several terms used to describe acute whiplash injury (AWI). Among them are acceleration-deceleration injury, hyperextension-hyperflexion injury, whiplash associated disorders just to name a few. Regardless of the description, the injury is caused by a rapid change in the position of the head which imparts energy transfer to the structures of the cervical spine, most commonly as a result of an automobile accident. A wide variety of symptoms may result to include cervical pain, headache, light headedness, tinnitus, jaw pain, or vision abnormalities. Long term symptoms are common (1).
Diagnosis of acute whiplash injury (AWI) is primarily based on history, examination and radiographic examination when necessary. The first concern to the physician is to determine the extent of injury to avoid interventions that may be harmful to the patient. Neurological and ligamentous injury resulting in laxity can result in negative outcomes if not recognized early in the intervention process. The following chart represents the commonly used standard of grading for AWI as developed by the Quebec Task Force (2):
|0||No neck complaints, no physical signs
|1||Complaints of neck pain, stiffness or tenderness. No physical signs.
|2||neck complaint and musculoskeletal signs
|3||Neck complaint and neurological signs
|4||Neck complaint and fracture/dislocation|
(1) Krakenes J, Kaale BR. Magnetic resonance imaging assessment of craniovertebral ligaments and membranes after whiplash trauma. Spine 2006; 31(24):2820-2826.; (2) Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining "whiplash" and its management. Spine 1995; 20(8 Suppl):1S-73S.