A 20-year prospective longitudinal MRI study on cervical spine after whiplash injury: Follow-up of a cross-sectional study

Kenshi Daimon, Hirokazu Fujiwara, Yuji Nishiwaki, Eijiro Okada, Kenya Nojiri, Kentaro Shimizu, Hiroko Ishihama, Nobuyuki Fujita, Daisuke Ichihara, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe

Research output: Contribution to journalArticle

Abstract

Background: Some patients suffer from long-lasting symptoms after whiplash injury. However, there are few reports on the long-term changes in the cervical spine after whiplash injury using imaging tests. The purpose of this longitudinal study was to determine the changes on MRI of the cervical spine 20 years after whiplash injury, and to examine the relationships between changes in the cervical spine on MRI and changes in related clinical symptoms. Methods: Eighty-one subjects finally participated in this study (follow-up rate 16%). The mean follow-up duration was 21.7 years. All subjects filled out a questionnaire about their clinical symptoms. The MRI findings were assessed using numerical grading system applied in the original study. Statistic analyses were used to investigate whether the progression of each MRI finding was associated with the severity of neck pain, stiff shoulders, dizziness and tinnitus. Results: All subjects had complained of some clinical symptoms in the original study: 71 had neck pain, 53 stiff shoulders, and others. In the present study, 66 subjects (81.5%) complained of some clinical symptoms: 57 had stiff shoulders, 20 neck pain, and others. The progression of degeneration on MRI was observed in 95% of the subjects, with C4/5 and 5/6 being the most frequently involved levels. Changes in the severity of neck pain, stiff shoulders, dizziness and tinnitus over 20 years were not significantly associated with the progression of degenerative changes in the cervical spine on MRI. Conclusions: Twenty years after whiplash injury, 95% of the subjects showed a progression of degeneration in the cervical spine. The progression of the intervertebral disc degeneration in the cervical spine on MRI after whiplash injury was not significantly associated with changes in the severity of related clinical symptoms, indicating that the degenerative changes on MRI may reflect the physiological aging process rather than post-traumatic sequelae.

Original languageEnglish
JournalJournal of Orthopaedic Science
DOIs
Publication statusAccepted/In press - 01-01-2018

Fingerprint

Whiplash Injuries
Longitudinal Studies
Spine
Neck Pain
Cross-Sectional Studies
Tinnitus
Dizziness
Physiological Phenomena
Intervertebral Disc Degeneration

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Daimon, Kenshi ; Fujiwara, Hirokazu ; Nishiwaki, Yuji ; Okada, Eijiro ; Nojiri, Kenya ; Shimizu, Kentaro ; Ishihama, Hiroko ; Fujita, Nobuyuki ; Ichihara, Daisuke ; Tsuji, Takashi ; Nakamura, Masaya ; Matsumoto, Morio ; Watanabe, Kota. / A 20-year prospective longitudinal MRI study on cervical spine after whiplash injury : Follow-up of a cross-sectional study. In: Journal of Orthopaedic Science. 2018.
@article{2cc8e736ddea4222b870ce2250ecb3e9,
title = "A 20-year prospective longitudinal MRI study on cervical spine after whiplash injury: Follow-up of a cross-sectional study",
abstract = "Background: Some patients suffer from long-lasting symptoms after whiplash injury. However, there are few reports on the long-term changes in the cervical spine after whiplash injury using imaging tests. The purpose of this longitudinal study was to determine the changes on MRI of the cervical spine 20 years after whiplash injury, and to examine the relationships between changes in the cervical spine on MRI and changes in related clinical symptoms. Methods: Eighty-one subjects finally participated in this study (follow-up rate 16{\%}). The mean follow-up duration was 21.7 years. All subjects filled out a questionnaire about their clinical symptoms. The MRI findings were assessed using numerical grading system applied in the original study. Statistic analyses were used to investigate whether the progression of each MRI finding was associated with the severity of neck pain, stiff shoulders, dizziness and tinnitus. Results: All subjects had complained of some clinical symptoms in the original study: 71 had neck pain, 53 stiff shoulders, and others. In the present study, 66 subjects (81.5{\%}) complained of some clinical symptoms: 57 had stiff shoulders, 20 neck pain, and others. The progression of degeneration on MRI was observed in 95{\%} of the subjects, with C4/5 and 5/6 being the most frequently involved levels. Changes in the severity of neck pain, stiff shoulders, dizziness and tinnitus over 20 years were not significantly associated with the progression of degenerative changes in the cervical spine on MRI. Conclusions: Twenty years after whiplash injury, 95{\%} of the subjects showed a progression of degeneration in the cervical spine. The progression of the intervertebral disc degeneration in the cervical spine on MRI after whiplash injury was not significantly associated with changes in the severity of related clinical symptoms, indicating that the degenerative changes on MRI may reflect the physiological aging process rather than post-traumatic sequelae.",
author = "Kenshi Daimon and Hirokazu Fujiwara and Yuji Nishiwaki and Eijiro Okada and Kenya Nojiri and Kentaro Shimizu and Hiroko Ishihama and Nobuyuki Fujita and Daisuke Ichihara and Takashi Tsuji and Masaya Nakamura and Morio Matsumoto and Kota Watanabe",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jos.2018.11.011",
language = "English",
journal = "Journal of Orthopaedic Science",
issn = "0949-2658",
publisher = "Springer Japan",

}

Daimon, K, Fujiwara, H, Nishiwaki, Y, Okada, E, Nojiri, K, Shimizu, K, Ishihama, H, Fujita, N, Ichihara, D, Tsuji, T, Nakamura, M, Matsumoto, M & Watanabe, K 2018, 'A 20-year prospective longitudinal MRI study on cervical spine after whiplash injury: Follow-up of a cross-sectional study' Journal of Orthopaedic Science. https://doi.org/10.1016/j.jos.2018.11.011

A 20-year prospective longitudinal MRI study on cervical spine after whiplash injury : Follow-up of a cross-sectional study. / Daimon, Kenshi; Fujiwara, Hirokazu; Nishiwaki, Yuji; Okada, Eijiro; Nojiri, Kenya; Shimizu, Kentaro; Ishihama, Hiroko; Fujita, Nobuyuki; Ichihara, Daisuke; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota.

In: Journal of Orthopaedic Science, 01.01.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A 20-year prospective longitudinal MRI study on cervical spine after whiplash injury

T2 - Follow-up of a cross-sectional study

AU - Daimon, Kenshi

AU - Fujiwara, Hirokazu

AU - Nishiwaki, Yuji

AU - Okada, Eijiro

AU - Nojiri, Kenya

AU - Shimizu, Kentaro

AU - Ishihama, Hiroko

AU - Fujita, Nobuyuki

AU - Ichihara, Daisuke

AU - Tsuji, Takashi

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Watanabe, Kota

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Some patients suffer from long-lasting symptoms after whiplash injury. However, there are few reports on the long-term changes in the cervical spine after whiplash injury using imaging tests. The purpose of this longitudinal study was to determine the changes on MRI of the cervical spine 20 years after whiplash injury, and to examine the relationships between changes in the cervical spine on MRI and changes in related clinical symptoms. Methods: Eighty-one subjects finally participated in this study (follow-up rate 16%). The mean follow-up duration was 21.7 years. All subjects filled out a questionnaire about their clinical symptoms. The MRI findings were assessed using numerical grading system applied in the original study. Statistic analyses were used to investigate whether the progression of each MRI finding was associated with the severity of neck pain, stiff shoulders, dizziness and tinnitus. Results: All subjects had complained of some clinical symptoms in the original study: 71 had neck pain, 53 stiff shoulders, and others. In the present study, 66 subjects (81.5%) complained of some clinical symptoms: 57 had stiff shoulders, 20 neck pain, and others. The progression of degeneration on MRI was observed in 95% of the subjects, with C4/5 and 5/6 being the most frequently involved levels. Changes in the severity of neck pain, stiff shoulders, dizziness and tinnitus over 20 years were not significantly associated with the progression of degenerative changes in the cervical spine on MRI. Conclusions: Twenty years after whiplash injury, 95% of the subjects showed a progression of degeneration in the cervical spine. The progression of the intervertebral disc degeneration in the cervical spine on MRI after whiplash injury was not significantly associated with changes in the severity of related clinical symptoms, indicating that the degenerative changes on MRI may reflect the physiological aging process rather than post-traumatic sequelae.

AB - Background: Some patients suffer from long-lasting symptoms after whiplash injury. However, there are few reports on the long-term changes in the cervical spine after whiplash injury using imaging tests. The purpose of this longitudinal study was to determine the changes on MRI of the cervical spine 20 years after whiplash injury, and to examine the relationships between changes in the cervical spine on MRI and changes in related clinical symptoms. Methods: Eighty-one subjects finally participated in this study (follow-up rate 16%). The mean follow-up duration was 21.7 years. All subjects filled out a questionnaire about their clinical symptoms. The MRI findings were assessed using numerical grading system applied in the original study. Statistic analyses were used to investigate whether the progression of each MRI finding was associated with the severity of neck pain, stiff shoulders, dizziness and tinnitus. Results: All subjects had complained of some clinical symptoms in the original study: 71 had neck pain, 53 stiff shoulders, and others. In the present study, 66 subjects (81.5%) complained of some clinical symptoms: 57 had stiff shoulders, 20 neck pain, and others. The progression of degeneration on MRI was observed in 95% of the subjects, with C4/5 and 5/6 being the most frequently involved levels. Changes in the severity of neck pain, stiff shoulders, dizziness and tinnitus over 20 years were not significantly associated with the progression of degenerative changes in the cervical spine on MRI. Conclusions: Twenty years after whiplash injury, 95% of the subjects showed a progression of degeneration in the cervical spine. The progression of the intervertebral disc degeneration in the cervical spine on MRI after whiplash injury was not significantly associated with changes in the severity of related clinical symptoms, indicating that the degenerative changes on MRI may reflect the physiological aging process rather than post-traumatic sequelae.

UR - http://www.scopus.com/inward/record.url?scp=85058179011&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058179011&partnerID=8YFLogxK

U2 - 10.1016/j.jos.2018.11.011

DO - 10.1016/j.jos.2018.11.011

M3 - Article

JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

ER -