Strength and kinematic response of dynamic cervical spine injuries.

This study was conducted to evaluate the biodynamic strength and localized kinematic response of the human cervical spine under axial loading applied to the head. Intact ligamentous fresh human cadaveric head-neck complexes were subjected to dynamic compressive forces with a custom-designed electrohydraulic testing device at varying rates. The structure included the effects of anterior and posterior cervical spine muscles with a system of pulleys, dead weights, and spring tension. Localized kinematic data were obtained from retroreflective targets placed on the bony landmarks of the specimen at every level of the spinal column. Input forces, accelerations, displacement, and output generalized force histories were recorded as a function of time with a digital data acquisition system at dynamic sampling rates in excess of 8,000 Hz. High-speed photography at 1,000-1,200 frames/sec also was used. Pathologic alterations to the head-neck complex were evaluated with conventional radiography, computed tomography, and cryomicrotomy. In all specimens, cervical spine injuries occurred as a result of impact. Compressive forces recorded at the distal end of the preparation indicated large-duration, short-magnitude pulses in contrast to short-duration, high-amplitude input waveforms at the head, suggesting decoupling characteristics of the head-neck system. Cervical vertebral body accelerations were consistently smaller than the accelerations recorded on the head. Kinematic data demonstrated temporal deformation characteristics as well as a plausible sequence of spinal deformations leading to injury, which were correlated with the pathoanatomic alterations documented with the post-test computed tomographic and sequential cryomicrotome sections.