Thursday, October 31, 2001 3:47–4:17 pm Focused Review: Cervical Spine Surgery Complications

Abstract Purpose of study: The purpose of this study was to investigate the incidence of neck pain and associated symptoms in an unusual population of car drivers with high-risk behaviors for whiplash disorder. Methods used: Fifty members of the Demolition Derby Association returned a neck pain questionnaire that had been contacted through the association's internet website. Questions included the participant's exposure to demolition activity (years of participation, estimated number of collisions, approximate impact velocity, and so forth; demolition-related acute and chronic neck pain symptoms, divided into worst and average events and nondemolition neck pain history. of findings: Of the 50 respondents, (44 male, 6 female), 40 completed the entire survey. Average age was 27.8 years (range, 18 to 46). Sixty-six percent were employed full time. Drivers had participated in an average of 11 events over the previous 3 years and an average of 30 events over their total careers. They reported an average of 48 car collisions per event, 54% of these being rear-end collisions. Eighty-four the respondents were restrained drivers all of the time. Thirty-six percent respondents reported that they never wear neck protective gear. Participants estimated average collision speed was 26 miles/hour. Their estimated average maximum collision speeds were 45 miles/hour. Ten of the 50 respondents reported injuries requiring a physician's evaluation, although only 3 reported visits to a physician regarding neck pain. Two of 40 reported their worst postparticipation neck pain to have lasted more than 3 months, 1 of 40 lasting more than 1 year, but for the majority the worst neck pain lasted less than 21 days (27 or 40 less than 21 days, 9 of 40 none). Three participants reported mild chronic persistent neck pain (never went away) as a result of demolition driving experience. The remainder reported none. The average episode of neck pain was moderate or severe for 8 of 40 participants, but for all respondents average pain episodes lasted less than 21 days. Thirteen of 40 respondents reported experiencing some form of chronic neck pain they felt was unrelated to derby competition (33 none, 10 mild, 2 moderate, 1 severe). Relationship between findings and existing knowledge: Considerable controversy surrounds the understanding of whiplash injury with regard to its significance in the causation of chronic symptomology. Some studies suggest that as many as 50% of collision victims report persistent pain 6 months after the collision. By contrast, studies performed in sociological settings where no remuneration for injury exists suggested recovery by 95% of subjects within 6 weeks or less. Participants of demolition derby sport willingly subject themselves to repetitive car collision trauma and might be subject to a high incidence of whiplash. Demolition derby participants reported having undergone high numbers of car collisions in their lifetime at low to medium velocity collision speeds. In spite of this repeated traumatic exposure, only 3 of 40 respondents attributed any chronic neck pain to the sport itself, and those who did rated it mild. Overall significance of findings: The possible injury to the cervical spine resulting from motor vehicle collision appears to result in significantly less chronic pain in this setting where there is little or no medicolegal remuneration. Further study of this unique population of car drivers offers the possibility of greater understanding of whiplash disorder. Disclosures: No disclosures. Conflict of interest: No conflicts.