Biomechanical assessment of soft tissue cervical spine disorders and expert opinion in low speed collisions.

ABSTRACT

The multidisciplinary research of injury mechanisms and injury prevention requires the assessment of the technical and biomechanical circumstances of a collision; moreover, the causality assessment in the individual cases is facilitated by taking these aspects into account. In fact, only specially trained engineers and biomechanical experts are in a position to evaluate these relevant basic facts. In many crucial court cases, important technical factors such as collision angle, structural stiffness, extent of intrusion and the vehicle's velocity change are often ignored. The purely medical causality assessment is often based only on a coincidence of time of the 'accident' and the onset of the disorders. Unfortunately, statements about the 'accident speed' or the nebulous 'accident energy' are often made by clinicians with neither a proper collision documentation nor the necessary biomechanical and technical background. In order to overcome shortcomings of injury causality assessment as well as the terminology associated with soft tissue cervical spine injuries, a subdivision of the term 'accident severity' into four classes is proposed. Consequently, an 'accident severity assessment' can only be performed by a collaboration of four corresponding classes of experts, i.e. the engineer (dynamic loading of the vehicle), the biomechanical expert (biomechanical loading of the occupant), the physician (clinically diagnosable injuries), and eventually the psychiatrist (subjective sequelae individually experienced by the victim).