Abstract
Purpose: The multitude of symptoms after a whiplash injury have caused a lot of discussion because of the lack of objective radiologic findings. However, in such a trauma the ligaments that stabilize the cervical spine and the skull to the spine can be injured. These injuries can seldom be seen on static radiographs but pathological motion patterns caused by the injury of these ligaments can be detected on functional kine MRI.
Methods and results: Thirty consecutive patients who had had a whiplash trauma and were clinically supposed to have a problem at the level of C0–C2 were included in the study. The control group consisted of age and sex matched healthy persons. Images of four patients were missing.
The imaging was performed with Philips Gyroscan Intera 1.5 T magnet. A manual therapist performed the bending and rotation of the upper cervical spine to the patients and controls to ensure that the movements were limited to the C0–C2 levels.
The analysis was made blinded and was done by one radiologist. The movement of the dens and the signal of the alaria ligaments were analysed.
Of the 26 patients, 11presented with a normal movement of the dens, whereas 15 presented with a pathological movement. Among controls we could see a normal movement in 24 individuals and pathological in 6 individuals.
Only one patient presented with a normal signal and a normal movement, whereas 20 controls presented with a normal signal as well as normal movement.
Conclusion: Functional kine MRI is a reliable method to find ligament injuries and movement disturbances between C0 and C2.
Correspondence should be addressed to: Mr John O’ Dowd, SBPR, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
