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ASTM Selected Technical Papers
Head and Neck Injuries in Sports
By
EF Hoerner, M.D.
EF Hoerner, M.D.
1
Chairman
, Subcommittee F08.51 on Medical Aspects and Biomechanics,
ASTM
Search for other works by this author on:
ISBN-10:
0-8031-1886-4
ISBN:
978-0-8031-1886-7
No. of Pages:
872
Publisher:
ASTM International
Publication date:
1994

Compression related mechanisms of injury are common in sports and recreational trauma to the human cervical spine. The purpose of these studies was to experimentally reproduce common clinically seen injuries of the head-neck complex. A total of 19 preparations (8 quasistatic, 11 dynamic) were used to obtain strength and motion information correlated to pathology. The quasistatic studies served to develope a method to kinematically monitor the localized deformations in the tissue as injury occurs. It was observed that significant relaxation of the tissues occur post-traumatically and the kinematic analysis quantified the true extent of the deformations to the cervical spine components. Under dynamic loading, mid to lower cervical spine compression-related trauma occurred. To reproduce these kinds of injuries, the pre-existing lordosis was removed and the head-neck complex was dynamically impacted. Parallel studies on the Hybrid III anthropomorphic manikin head-neck indicated a substantially different response in compression compared to the human cadaver specimens.

1.
Torg
,
T. S.
,
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, 2nd Edition,
Mosby - Year Book, Inc.
,
St. Louis, MO
,
1991
, 694 pp.
2.
Cusick
,
J. F.
,
Yoganandan
,
N.
,
Pintar
,
F.
,
Myklebust
,
J.
, and
Hussain
,
H.
, “
Biomechanics of Cervical Spine Facetectomy and Fixation Techniques
,”
Spine
, Vol.
13
, No.
7
,
1988
, pp 808–812.
3.
Goel
,
V. K.
,
Clark
,
C.
,
McGowan
,
D.
, and
Goyal
S.
, “
An in vitro Study of the Kinematics of the Normal, Injured and Stabilized Cervical Spine
,”
Journal of Biomechanics
, Vol.
17
,
1984
, pp 363–376.
4.
Liu
,
Y. K.
,
Krieger
,
K. W.
,
Jnus
,
G. O.
,
Connors
,
M. P.
,
Wakano
,
P.
, and
Thies
,
D.
, “
Cervical Spine Stiffness and Geometry of the Young Human Male
,”
Wright Patterson AFB
, Dayton, OH, AFAMRL-TR-80-138,
1983
.
5.
Moroney
,
S.
,
Schultz
,
A.
,
Miller
,
J.
,
Gunnar
,
B.
, and
Andersson
,
J.
, “
Load-displacement Properties of Lower Cervical Spine Motion Segments
,”
Journal of Biomechanics
, Vol.
21
, No.
9
,
1988
, pp 767–779.
6.
Panjabi
,
M. M.
,
White
,
A. A.
, and
Johnson
,
R. M.
, “
Cervical Spine Mechanics as a Function of Transection of Components
,”
Journal of Biomechanics
, Vol.
8
,
1975
, pp 327–336.
7.
Pintar
,
F. A.
,
Myklebust
,
J. B.
,
Yoganandan
,
N.
,
Maiman
,
D. J.
, and
Sances
,
A.
 Jr.
, “
Biomechanics of Human Spinal Ligaments
.” In Mechanisms of Head and Spine Trauma,
Sances
,
A.
 Jr.
,
Thomas
D. J.
,
Ewing
C. L.
,
Larson
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,
Unterharnscheidt
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, Eds.,
Aloray Publisher
,
Goshen, New York
,
1986
, pp 505–527.
8.
Sances
,
A.
 Jr.
,
Myklebust
,
J. B.
,
Maiman
,
D. J.
,
Larson
,
S. J.
,
Cusick
,
J. F.
, and
Jodat
,
R.
, “
Biomechanics of Spinal Injuries
,”
CRC Critical Reviews in Bioengineering
, Vol.
11
, No.
1
,
1984
, pp 1–76.
9.
Sances
,
A.
 Jr.
,
Thomas
,
D. J.
,
Ewing
,
C. L.
,
Larson
,
S. J.
,
Unterharnscheidt
,
F.
, Eds.
Mechanisms of Head and Spine Trauma
,
Aloray Publisher
,
Goshen, NY
,
1986
, 746 pp.
10.
White
,
A. A.
and
Panjabi
,
M. M.
,
Clinical Biomechanics of the Spine
, 2nd Edition,
J. B. Lippincott Company
,
Philadelphia, PA
,
1990
, 722 pp.
11.
Yoganandan
,
N.
,
Pintar
,
F.
,
Butler
,
J.
,
Reinartz
,
J.
,
Sances
,
A.
 Jr.
, and
Larson
,
S. J.
, “
Dynamic Response of Human Cervical Spine Ligaments
,”
Spine
, Vol.
14
, No.
10
,
1989
, pp 1102–1110.
12.
Alem
,
N. M.
,
Nusholtz
,
G. S.
, and
Melvin
,
J. W.
, “
Head and Neck Response to Axial Impacts
,” Proceedings of the 28th Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 841667,
Warrendale, PA
,
1984
, pp 275–288.
13.
Hodgson
,
V. R.
and
Thomas
,
L. M.
, “
Mechanisms of Cervical Spine Injury During Impact to the Protected Head
,” Proceedings of the 24th Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 801300,
Warrendale, PA
,
1980
, pp 15–42.
14.
Hodgson
,
V. R.
and
Thomas
,
L. M.
, “
A Model to Study Cervical Spine Injury Mechanisms Due to Head Impact
,”
Institution of Mechanical Engineering
,
London
,
1980
, pp 89–96.
15.
McElhaney
,
J. H.
,
Paver
,
J. G.
,
McCrackin
,
J. H.
, and
Maxwell
,
G. M.
, “
Cervical Spine Compression Responses
,” Proceedings of the 27th Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 831615,
Warrendale, PA
,
1983
, pp 163–178.
16.
McElhaney
,
J. H.
,
Doherty
,
B. J.
,
Paver
,
J. G.
, and
Myers
,
B. S.
, “
Combined Bending and Axial Loading Responses of the Human Cervical Spine
,” Proceedings of the 32nd Stapp Car Crash Conference,
Society Automotive Engineers
, Paper No. 881709,
Warrendale, PA
,
1988
, pp 21–28.
17.
Mertz
,
H. J.
and
Patrick
,
L. M.
, “
Strength and Response of the Human Neck
,” Proceedings of the 15th Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 710855,
New York, NY
,
1971
, pp 207–255.
18.
Myers
,
B. S.
,
McElhaney
,
J. H.
,
Doherty
,
B. J.
,
Paver
,
J. G.
,
Nightingale
,
R. W.
,
Ladd
,
T. P.
, and
Gray
,
L.
, “
Responses of the Human Cervical Spine to Torsion
,” Proceedings of the 33rd Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 892437,
Warrendale, PA
,
1989
, pp 215–222.
19.
Nusholtz
,
G. S.
,
Melvin
,
J. W.
,
Huelke
,
D. F.
,
Alem
,
N. M.
, and
Blank
,
J. G.
, “
Response of the Cervical Spine to Superior-Inferior Head Impact
,” Proceedings of the 25th Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 811005,
Warrendale, PA
,
1981
, pp 197–237.
20.
Nusholtz
,
G. S.
,
Huelke
,
D. E.
,
Lux
,
P.
,
Alem
,
N. M.
, and
Montalvo
,
F.
, “
Cervical Spine Injury Mechanisms
,” Proceedings of the 27th Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 831616,
Warrendale, PA
,
1983
, pp 179–197.
21.
Pintar
,
F. A.
,
Yoganandan
,
N.
,
Sances
,
A.
 Jr.
,
Reinartz
,
J.
,
Harris
,
G.
, and
Larson
,
S. J.
, “
Kinematic and Anatomical Analysis of the Human Cervical Spinal Column Under Axial Loading
,” Proceedings of the 33rd Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 892436,
Warrendale, PA
,
1989
, pp 191–214.
22.
Pintar
,
F. A.
,
Sances
,
A.
 Jr.
,
Yoganandan
,
N.
,
Reinartz
,
J.
,
Maiman
,
D. J.
, and
Suh
,
J. K.
, “
Biodynamics of the Total Human Cadaveric Cervical Spine
,” Proceedings of the 34th Stapp Car Crash Conference,
Society of Automotive Engineers
, Paper No. 902309,
Warrendale, PA
,
1990
, pp 55–72.
23.
Prasad
,
P.
,
King
,
A. L.
, and
Ewing
,
C. L.
, “
The Role of Articular Facets During +Gz Acceleration
,”
Applied Mechanics
,
06
1974
, pp 321–326.
24.
Yoganandan
,
N.
,
Sances
,
A.
 Jr.
,
Maiman
,
D. J.
,
Myklebust
,
J. B.
,
Pech
,
P.
, and
Larson
,
S. J.
, “
Experimental Spinal Injuries With Vertical Impact
,”
Spine
, Vol.
11
, No.
9
,
1986
, pp 855–860.
25.
Yoganandan
,
N.
,
Sances
,
A.
 Jr.
, and
Pintar
,
F. A.
, “
Biomechanical Evaluation of the Axial Compressive Responses of the Human Cadaveric and Manikin Necks
,”
Journal of Biomechanical Engineering
, Vol.
111
, No.
3
,
1989
, pp 250–255.
26.
Schlick
,
M. B.
,
Pintar
,
F. A.
,
Yoganandan
,
N.
,
Maiman
,
D. J.
, and
Sances
,
A.
 Jr.
, “
An Instrumented Physical Spinal Cord Model for In Situ Pressure Measurement
,” Proceedings of the 15th Annual Meeting of the American Society of Biomechanics, Oct. 16–18, 1991, pp 102–103.
27.
Liu
,
Y. K.
and
Dai
,
Q. G.
, “
The Second Stiffest Axis of a Beam-column: Implications for Cervical Spine Trauma
,”
Journal of Biomechanical Engineering
, Vol.
111
, No.
2
,
05
1989
, pp 122–127.
28.
Myers
,
B. S.
,
McElhaney
,
J. H.
,
Richardson
,
W. J.
,
Nightingale
,
R. W.
, and
Doherty
,
B. J.
, “
The Influence of End Condition on Human Cervical Spine Injury Mechanisms
,” Proceedings of the 35th Stapp Car Crash Conference,
Society of Automative Engineers
, Paper No. 912915,
Warrendale, PA
,
1991
, pp 391–400.
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