2. 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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3. • 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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4. • 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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5. 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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6. ..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.
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8. 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, an
d 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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9. 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
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10. 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.
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11. 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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12. 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…
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13. 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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14. 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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15. Better position!
Too low & too far away!
Headrests in car can reduce the severity of neck pain from a car
accident.
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16. 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)
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