Cervical spinal cord deformation during simulated head-first impact injuries

• Published in: Journal of biomechanics Vol. 44; no. 14; pp. 2565 - 2571
• Main Authors: Saari, A, Itshayek, E, Cripton, P.A
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 23.09.2011; Elsevier; Elsevier Limited
• Subjects: Adult and adolescent clinical studies; Aged; Anatomy & physiology; Biological and medical sciences; Biomechanical Phenomena; Biomechanics; Cadaver; Cerebrospinal fluid. Meninges. Spinal cord; Cervical spine; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - injuries; Cineradiography; Craniocerebral Trauma - complications; Craniocerebral Trauma - diagnostic imaging; Deformation; Female; Head-first impact; High speed; Humans; Injuries; Injuries of the nervous system and the skull. Diseases due to physical agents; Injury; Male; Medical sciences; Mustela putorius furo; Nervous system (semeiology, syndromes); Neurology; Organic mental disorders. Neuropsychology; Physical Medicine and Rehabilitation; Posture; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Radiography; Spinal Cord - diagnostic imaging; Spinal Cord Compression - diagnostic imaging; Spinal Cord Compression - etiology; Spinal cord injuries; Spinal Cord Injuries - diagnostic imaging; Spinal Cord Injuries - etiology; Spinal cord injury; Studies; Traumas. Diseases due to physical agents; Biomechanics; Injury; Head-first impact; Spinal cord injury; Cineradiography; Cervical spine; Cadaver; Human; Nervous system diseases; Head; Deformation; Radiodiagnosis; Pathophysiology; Cervical spinal cord; Radiocinematography; Spinal cord trauma; Central nervous system disease; Head trauma; Spinal cord disease; Biomedical engineering
• ISSN: 0021-9290; 1873-2380
• DOI: 10.1016/j.jbiomech.2011.06.015

Abstract The relationship between bony spinal column and spinal cord injury during an injury event is not well understood. While several studies have measured spinal canal occlusion during axial impact, there has been limited work done to quantify the spinal cord compression or deformation during simulated injury. Because the cord is a viscoelastic solid it may provide resistance to bone fragments, ligaments or other elements that move into the canal and impinge it during column injury. This would differentiate the measurement of cord compression from the measurement of occlusion of an empty canal. In the present study, a novel method of visualizing and quantifying spinal cord deformation during dynamic head-first impact of ex vivo human cervical spine specimens ( N =6) was developed. A radiodense, biofidelic surrogate spinal cord was imaged in the spinal canal using high speed cineradiography at 1000 frames per second. The dorsal–ventral diameter of the cord was measured at 1.5 mm increments along its length for each frame of the radiographic footage. The resulting cord deformations were used to determine the theoretical neurological outcome of the impact based on published in vivo ferret studies. The corresponding probability of recovery for the spinal cord deformations in these tests ranged between 8% for atlantoaxial dislocation injury and 95% for mid-cervical spine hyperextension injury (based on the ferret data). Clinically relevant spinal column fracture patterns were produced in this study.