A neck injury rate of up to 30% has been reported for older adult occupants of rear motor vehicle collisions (RMVCs) and older adults experience longer recovery times, as compared to younger RMVC occupants. Females experience higher neck injury risk and longer recovery times, as compared to males. Some epidemiological studies have found head restraints to be ineffective, while others have reported an effectiveness rate reaching only 20% for neck injury reduction. ? ? The specific hypotheses are: 1) for each spinal level, prevention of neck injuries in older adults (biomechanical instability, and ligamentous, neural and/or vascular injuries) depends upon the specific neck injury prevention system; and 2) for each neck injury prevention system, the potential neck injury severity depends upon the occupant gender and peak RMVC acceleration. ? ? There are three specific aims: 1) to advance our biomechanical understanding of traumatic neck injuries by developing a Human Model of the Neck (HUMON) and RMVC simulation apparatus in our experimental laboratory. HUMON will consist of a fresh-frozen human cadaveric specimen (entire head and neck through to T1 vertebra) stabilized with muscle force replication, mounted to the torso of an anthropometric test dummy. All specimens will be obtained from older adult donors, above 65 years of age, with an equal number of males and females. The RMVC simulation apparatus will include an automobile seat (with HUMON in it) rigidly attached to a sled on linear bearings, impacting mass and its power system, and a braking system; 2) to determine the human neck injury tolerance due to RMVC. HUMON, without a head restraint, will be used to obtain baseline data (n=20; 10 males and 10 females) during simulated RMVC, to determine the human neck injury tolerance, differences among gender, and to validate its dynamic biofidelity against in vivo data. Neck injuries (biomechanical instability) will be quantified using flexibility testing before and after each RMVC. During the RMVCs, ligament strains, spinal canal and intervertebral foramen narrowing, and vertebral artery elongation (potential injuries to neural and ligamentous tissues and vertebral artery) will be determined using custom transducers and a high speed digital camera. Intact and post-RMVC imaging (CT and MRI) will document clinical injuries. Neck injuries and their prevention will be documented by measuring dynamic intervertebral motions and spinal loads. All neck injury criteria (IV-NIC, NDC, NIC, Nij, Nkm) will be compared. ? ? Specific Aim 3 is to evaluate the effectiveness of the active head restraint and energy absorbing seat for neck injury prevention. The protocol of Aim 2 will be repeated to evaluate the role of two newly developed active injury prevention systems in reducing neck injury severity in older adults during RMVCs: active head restraint (n=20; 10 males and 10 females), and energy absorbing seat (n=20; 10 males and 10 females). Differences in neck injury severity among gender will be determined. ? ? The present data, obtained using older adult specimens, above 65 years of age, will: 1) advance our biomechanical understanding of traumatic neck injuries; 2) quantify the human neck injury tolerance due to rear motor vehicle collisions; 3) evaluate the effectiveness of the active head restraint and energy absorbing seat for neck injury prevention during the collisions; and 4) determine differences among gender. The proposed project will provide important research-based data that may form the basis for future safety standards and help to decrease the frequency and severity of neck injuries in older adults, thus benefiting society. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Center for Injury Prevention and Control (NCIPC)
Type
Research Project (R01)
Project #
5R01CE001257-02
Application #
7493993
Study Section
Special Emphasis Panel (ZCE1-JXS (06))
Program Officer
Childress, Adele M
Project Start
2007-09-01
Project End
2010-08-31
Budget Start
2008-09-01
Budget End
2009-08-31
Support Year
2
Fiscal Year
2008
Total Cost
$290,789
Indirect Cost
Name
Yale University
Department
Type
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Ivancic, P C (2014) Cervical spine instability following axial compression injury: a biomechanical study. Orthop Traumatol Surg Res 100:127-33
Ivancic, Paul C (2013) Neck injury response to direct head impact. Accid Anal Prev 50:323-9
Ivancic, Paul C (2012) Atlas injury mechanisms during head-first impact. Spine (Phila Pa 1976) 37:1022-9
Ivancic, Paul C (2012) Biomechanics of sports-induced axial-compression injuries of the neck. J Athl Train 47:489-97
Ivancic, Paul C (2012) Cervical neural space narrowing during simulated rear crashes with anti-whiplash systems. Eur Spine J 21:879-86
Ivancic, Paul C; Xiao, Ming (2011) Understanding whiplash injury and prevention mechanisms using a human model of the neck. Accid Anal Prev 43:1392-9
Curatolo, Michele; Bogduk, Nikolai; Ivancic, Paul C et al. (2011) The role of tissue damage in whiplash-associated disorders: discussion paper 1. Spine (Phila Pa 1976) 36:S309-15
Ivancic, Paul C (2011) Does knowledge of seat design and whiplash injury mechanisms translate to understanding outcomes? Spine (Phila Pa 1976) 36:S187-93
Ivancic, Paul C (2011) Facet joint and disc kinematics during simulated rear crashes with active injury prevention systems. Spine (Phila Pa 1976) 36:E1215-24
Ivancic, Paul C; Xiao, Ming (2011) Cervical spine curvature during simulated rear crashes with energy-absorbing seat. Spine J 11:224-33

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