Mechanisms Underlying Chronic Whiplash: Contributions from an Incomplete Spinal Cord Injury?

ObjectiveTo explore the association between findings on advanced, but available, magnetic resonance imaging (MRI) sequences of the cervical spinal cord and muscular system, in tandem with biomechanical measures of maximum volitional plantar flexion torques as a proxy for a mild incomplete spinal cord injury. DesignObservational case series. SettingUniversity research laboratory. SubjectsThree patients with chronic whiplash and one patient with history of whiplash injury but no current symptoms. MethodsWe measured lower extremity muscle fat, morphological changes in descending spinal cord pathways with advanced MRI applications and maximal activation of the plantar flexors. ResultsLarger magnitudes of lower extremity muscle fat corresponded to altered spinal cord anatomy and reductions in the ability to maximally activate plantar flexor torques in the three subjects with chronic whiplash. Such findings were not present in the recovered participant. ConclusionsThe potential value of MRI to quantify neuromuscular degeneration in chronic whiplash is recognized. Larger scaled prospective studies are warranted before stronger conclusions can be drawn.