“Some patients in the author’s study had associated injuries.  In addition to injuring their necks, they sprained their ankles or broke their wrists.  Normal painless function returned to their ankles and wrists in the expected period of time. These patients did not complain for month after month about painful ankles or wrists, but they did still complain of neck pain.  It is difficult to understand why litigation neurosis in these instances should be confined to the neck.” 

Ian Macnab 

Associate Professor of Surgery, University of 

Toronto 

Chief of Division of Orthopaedic Surgery, 

Wellesley Hospital, Toronto. 

“Acceleration Extension Injuries of the Cervical 

Spine” Chapter 10 in THE SPINE by Rothman and 

Simeone.

“Acceleration depends on the force applied and the inertia of the vehicle that has been struck. The force is dependent upon the weight and speed of the striking vehicle, so that a streetcar 

traveling as 3 mph can apply as much force and initiate the same degree of acceleration as a compact car traveling at 40 mph.” 

Ian Macnab 

Associate Professor of Surgery, University of 

Toronto 

Chief of Division of Orthopaedic Surgery, 

Wellesley Hospital, Toronto.

“Acceleration Extension Injuries of the Cervical 

Spine” Chapter 10 in THE SPINE by Rothman 

and Simeone. 

WB Saunders Company 

1982 

Page 648

“The amount of damage sustained by the car bears little relationship to the force applied.  To take an extreme example: If the car was struck in concrete, the damage sustained might be very great but the occupants would not be injured because the car could not move forward, whereas, on ice, the damage to the car could be slight but the injuries sustained might be severe 

because of the rapid accelerations permitted.”

Ian Macnab 

Associate Professor of Surgery, University of Toronto 

Chief of Division of Orthopaedic Surgery, 

Wellesley Hospital, Toronto. 

“Acceleration Extension Injuries of the Cervical 

Spine” Chapter 10 in THE SPINE by Rothman 

and Simeone. 

WB Saunders Company 

1982 

Page 648

Manipulation 

[“Little known sequelae of sprains of the cervical spine”] 

Schweiz Rundsch Med Prax. 

[This is a German journal, and the article is in 

German.  The abstract is also in English] 

December 2, 1999 

88(49):2021-4. 

Kaeser HE, Ettlin T. 

“After cervical sprain not only pain and 

neuropsychological disturbances may occur, but 

also the following sequelae: cervical dystonia, and 

torticollis, dizziness, hearing loss for low 

frequencies, dysphonia and globus.” 

[Globus is a sensation of something stuck or of a 

lump or tightness in the throat.] 

“Except for dystonia the symptoms often 

respond to manipulation of a blocked articulation 

between occiput and atlas or axis and the third 

cervical vertebra.”

Whiplash Injuries 

“Follow-up roentgenograms taken an average of 7 years after 

injury in one series of patients without prior roentgenographic 

evidence of disc disease indicated that 39% had developed 

degenerative disc disease at one or more disc levels since 

injury.” 

There was an expected incidence of 6% degenerative change 

in the population over this period of time. 

“Thus, it appeared that the injury had started the slow process 

of disc degeneration.”