Railway spine & Whiplash injury

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Railway SpineandWhiplash Injuryby Amarendra B. Singh

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04/12/2023 Railway Spine & Whiplash - Amarendra 090201263

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Railway Spine

• 1867 – following a series of deadly train accidents in Great Britain.

• Soon a group of people started coming forward who claimed that they had been injured in train crashes, but had no obvious evidence of injury. The railroads rejected these claims as fake.


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• Germany's leading neurologist,

claimed that all railway spine symptoms were due to physical damage to the spine or brain.

• whereas French and British scholars,

insisted that some symptoms could be caused by hysteria (now known as conversion disorder).

The nature of symptoms caused by "railway spine" was hotly debated in the late 19th century,


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• In the case of railway spine two opposing views (one that the patient is malingering, the other that the spine is chronically damaged) eventually gave way to a third theory, that of traumatic neurosis (PTSD).

• Blunt force over vertebral column can lead to concussion of spinal cord without visible injury to vertebrae.

• This is called Railway Spine due to its frequent occurrence in rail accidents.


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Symptoms of Railway Spine (as described by erichsen)

• Memory Impairment• Poor concentration• Sleep disturbance• Anxiety • Irritability• Back stiffness and pain• Headache• Hearing Problems• Extremity Numbness• Arm and Hand Pain• Loss of sexual desire


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..contd

This condition occurs without any evidence of external injury to the spinal column.

Commonest region affected is Lumbo-sacral spine resulting in paraplegia, bladder disturbances, and impotence.

Since concussion is spontaneously reversible, these abnormalities are usually only temporary.

WHIPLASH INJURY


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What is Whiplash Injury?

Definition:

• Whiplash is an acute injury of at least moderate intensity which causes a strain to the bones, muscles, nerves, tendons, and vertebral discs of the neck region. It is caused by a sudden, unexpected impact which jerks the head back and then forward causing the neck to snap out of alignment.


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Where Could It Happen?

• Stopped at the traffic light

• Traffic jam

• Sports (Rugby / Boxing / Karate / Judo…)

• Roller Coaster

• Whiplash is also one of the hallmarks of shaken baby syndrome.


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Mechanics of Whiplash

Hyperextension HyperFlexion

Due to a sudden and violent jerk hyperflexion or hyperextension of the tissues and joints of the neck occurs.

As a result, the muscles and nerves may be torn or stretched, and bones slightly displaced, thus irritating nerves, interfering with blood flow and nerve impulse transmission.

Majority of cases, no injury can be identified


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What Are The Symptoms?

• Headaches / Migraines

• Stiffness, neck pain

• Dizziness (nausea/vomiting)

• Problems thinking or remembering

• Numbness & tingling (arms, face, shoulders)

• Jaw pain, low back pain, hip pain

• Impaired vision


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What Happens to the Driver?

What happens during a rear end collision if:– Head restraint

– Seat position

– Seat belt height

Are not adjusted correctly?

1. Body moves up (depending in angle of backrest and position of seat belt adjustor)

2. Head jerks back…

3. Pushing the head restraint down


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What Are The Facts?• Even low speed accidents can cause significant injuries

depending on where and how hard your car got hit, your position in the car, the position of your head, type of seat, position of the headrest, your pre-accident medical condition, and other things.

• Only 12% of persons who suffer from whiplash are symptom-free after 10 years

• Saab was the first to introduce an active protection system (SAHR); Volvo’s “Whiplash Protection Seating System” reduces acceleration forces on the neck by up to 50 %

• A study by Young et al. (2005) showed that 93% of all head restraints observed were sub-optimally positioned.

(A L Young, B T Ragel, E Su, C N Mann, E H Frank: Assessing

automobile head restraint positioning in Portland, Oregon; Injury Prevention 2005; 11: 97-101.)


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How Can It Be Prevented?• Ensure that the top of the head restraint is as high as the top of your head• Position the head restraint as close to the rear of your head as possible

7 cm

6 cm

Terminology

Adjust your head restraint


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Better position!

Too low & too far away!

Headrests in car can reduce the severity of neck pain from a car accident.

http://restraint-animated2.gif/


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How Can It Be Prevented? ..contd

• Adjust head restraint – not only in your own car!

• Adjust seat position

• Check seat belt adjustor position

• Leave plenty of space (escape route) if you are the last car

in a traffic jam – closely observe oncoming traffic in rear

view mirror

• Look up safety ratings before buying your next car (see

links below)

Useful Links

http://www.euroncap.com/ (European New Car Assessment Programme)

http://www.hwysafety.org/ (Insurance Institute for Highway Safety – USA)

http://www.aap.org/family/carseatguide.htm (American Academy of Paediatrics – Infant Car Seats)

http://www.thinkroadsafety.gov.uk/ (Department of Transport (UK) – Multiple Topics)

http://www-nrd.nhtsa.dot.gov/pdf/nrd-51/MisBio/headpos.pdf (Head Restrained Related Info)

http://www.euroncap.com/

http://www.hwysafety.org/

http://www.aap.org/family/carseatguide.htm

http://www.thinkroadsafety.gov.uk/

http://www-nrd.nhtsa.dot.gov/pdf/nrd-51/MisBio/headpos.pdf


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Thank You!

Education

Railway spine & Whiplash injury