James M Elliott1, Todd B Parrish2, David M Walton3, Amy J Vassallo4, Joel Fundaun5, Marie Wasielewski5, D Mark Courtney6. 1. The University of Sydney, Faculty of Health Sciences & the Northern Sydney Local Health District, The Kolling Institute, St. Leonards, NSW, Australia; Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: jim.elliott@sydney.edu.au. 2. Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA. 3. School of Physical Therapy, Western University, London, Ontario, Canada. 4. The University of Sydney, Faculty of Health Sciences & the Northern Sydney Local Health District, The Kolling Institute, St. Leonards, NSW, Australia. 5. Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 6. Department of Emergency Medicine Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Abstract
BACKGROUND AND PURPOSE: There remains limited evidence for the clinical importance of most imaging findings in whiplash. However, it is possible the type and number of findings on Computed Tomography (CT) may contribute to prognostic recovery models. The purpose is to interpret cervical spine pathologies in the context of known factors influencing recovery. MATERIALS AND METHODS: This is a secondary analysis from a database of 97 acutely injured participants enrolled in a prospective inception cohort study. Thirty-eight participants underwent standard of care cervical spine CT in the emergency medicine department. All 38 participants were assessed at <1-week, 2-weeks, and 3-months post-injury and classified using percentage scores on the Neck Disability Index (recovered/mild (NDI of 0-28%) or moderate/severe (NDI ≥ 30%)). Between-group comparison of categorical variables (gender (male/female), presence of at least one CT finding (yes/no), and presence of ≥3 pathologies on CT (yes/no)) was conducted using 2-tailed Fisher's exact test. RESULTS: Participants from both groups demonstrated at least one observable pathology. The group with persistent moderate/severe symptoms presented with significantly more pathology at baseline than those who later reported recovery or milder symptoms at 3-months post injury (p = 0.02). CONCLUSIONS: This preliminary study, which needs replication in a larger cohort, provides foundation that the number of degenerative pathologies seen on initial post MVC CT may be associated with the subsequent clinical course of whiplash.
BACKGROUND AND PURPOSE: There remains limited evidence for the clinical importance of most imaging findings in whiplash. However, it is possible the type and number of findings on Computed Tomography (CT) may contribute to prognostic recovery models. The purpose is to interpret cervical spine pathologies in the context of known factors influencing recovery. MATERIALS AND METHODS: This is a secondary analysis from a database of 97 acutely injured participants enrolled in a prospective inception cohort study. Thirty-eight participants underwent standard of care cervical spine CT in the emergency medicine department. All 38 participants were assessed at <1-week, 2-weeks, and 3-months post-injury and classified using percentage scores on the Neck Disability Index (recovered/mild (NDI of 0-28%) or moderate/severe (NDI ≥ 30%)). Between-group comparison of categorical variables (gender (male/female), presence of at least one CT finding (yes/no), and presence of ≥3 pathologies on CT (yes/no)) was conducted using 2-tailed Fisher's exact test. RESULTS:Participants from both groups demonstrated at least one observable pathology. The group with persistent moderate/severe symptoms presented with significantly more pathology at baseline than those who later reported recovery or milder symptoms at 3-months post injury (p = 0.02). CONCLUSIONS: This preliminary study, which needs replication in a larger cohort, provides foundation that the number of degenerative pathologies seen on initial post MVC CT may be associated with the subsequent clinical course of whiplash.
Authors: Scott F Farrell; Ashley D Smith; Mark J Hancock; Alexandra L Webb; Michele Sterling Journal: J Magn Reson Imaging Date: 2019-01-05 Impact factor: 4.813
Authors: Andrew C Smith; Stephanie R Albin; Rebecca Abbott; Rebecca J Crawford; Mark A Hoggarth; Marie Wasielewski; James M Elliott Journal: Sci Rep Date: 2020-07-10 Impact factor: 4.379