The reason why whiplash exists and possible treatments
4th International Conference on Spine and Spinal Disorders
September 03-04, 2019 | London, UK
Gert Holstege
University of Groningen, The Netherlands
Keynote : J Neurol Neurorehabil Res
Abstract:
Whiplash Associated Disease (WAD) is a disease many
people suffering from. More than 75% of the cases are
caused by car accidents in which the car driver, waiting in line
because of a red traffic light or a traffic block, is hit by another
car from behind. In most cases this accident is completely
unexpected for the driver in the front car, which means that the
neck muscles of this driver were relaxed during the accident.
During the collision the trunk of the driver in the front car is
pushed forward with the head staying behind, resulting in
a sudden and strong stretching of the relaxed anterior neck
muscles. Subsequently, when the front car stops, the body of
the driver is pushed backward leaving the head in an anterior
position resulting in very strong stretching of the posterior
neck muscles. This strong flexion-extension movement often
causes large damage of the neck muscles and of the facet
joints, capsules and ligaments of the upper cervical vertebrae.
These neck muscles and upper cervical facet joints and
ligaments send a large amount of information to the spinal
cord regarding the position of the head in space. In the upper
cervical spinal cord this information is relayed to higher
brain levels of which the mesencephalic periaqueductal gray
(PAG) and adjoining areas are the most important. Other
information regarding the position of the head originates from
the vestibular nuclei and from the visual system. Based on
this information the mesencephalon determines the position
of the head and the eyes. In WAD-patients the damaged
neck muscles and upper cervical vertebrae deliver incorrect
proprioceptive information to the PAG, resulting in a mismatch
between this information and the incoming information from
the undamaged vestibular and visual systems. This mismatch
causes balance disturbances, dizziness, headache, and central
hypersensitivity to pain, the common symptoms in WAD
patients. How to correct this mismatch will be discussed. Such
a correction might lead to treatments of WAD, a disorder with
an estimated yearly cost in Europe of at least € 10.000.000.000.
Biography:
Gert Holstege is a Neuroscientist at University of Groningen in the Netherlands. He studied Medicines at Erasmus University Rotterdam from 1966 to 1971. He was Neuroscientist at Erasmus University Rotterdam from 1971 to 1987, after which he worked for four years for NASA in Mountain View, California. Since 1990, he has worked at University of Groningen, where he has been a Full Professor of Neuroanatomy since 1993 and Chairman of the Department of Anatomy and Embryology at Faculty of Medicine.
E-mail: holstege23@gmail.com
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