Morphology of Cervical Spine Meniscoids in Individuals With Chronic Whiplash-Associated Disorder: A Case-Control Study

STUDY DESIGN: Case-control study. BACKGROUND: Cervical spine meniscoids are thought to contribute to neck pain and hypomobility in individuals with chronic whiplash-associated disorder (WAD); however, their morphology has not been studied in a clinical population. OBJECTIVES: To investigate cervical spine meniscoid morphology in individuals with chronic WAD. METHODS: Twenty volunteers with chronic WAD (mean +/- SD age, 39.3 +/- 11.0 years; 10 female) and 20 age- and sex-matched controls (age, 39.1 +/- 10.6 years) underwent cervical spine Magnetic resonance imaging. Lateral atlantoaxial and zygapophyseal joints (C2-3 to C6-7) were inspected for meniscoids. Length of meniscoid protrusion was measured and composition (adipose/fibrous/fibroadipose) assessed. Data were analyzed using Wilcoxon signed-rank tests and linear and logistic regression (P<.05). RESULTS: Meniscoids were identified in the chronic WAD (n = 317) and control (n = 296) groups. At the lateral atlantoaxial joints, median meniscoid length was greater in the control group (ventral, 6.07 mm; dorsal, 7.24 mm) than the WAD group (ventral, 5.01 mm; P = .06 and dorsal, 6.48 mm; P<.01). At the dorsal aspect of zygapophyseal joints, meniscoids were more frequently fibrous in the chronic WAD group (odds ratio = 2.38, P<.01; likelihood ratio test: chi(2)(2), 9.02; P = .01). CONCLUSION: In individuals with chronic WAD, lateral atlantoaxial meniscoids were shorter and dorsal cervical zygapophyseal meniscoids were more fibrous, suggesting alterations in meniscoid composition. This may have pathoanatomical implications in chronic WAD.