Halswirbelsäulendistorsion

Because of the insecure status of knowledge about the actual pathomorphologic changes that occur in whiplash injury, the diagnosis, therapy, and expert assessment of its sequelae still present considerable problems. These are further compounded by the high incidence of this injury in Germany and the very good insurance cover the persons concerned generally have. The initial diagnostic examinations should include a detailed and well-documented clinical examination, and the most precise record possible of how the injury was sustained should be elicited. Plain X-rays are standard diagnostic procedures; functional X-rays and MRI are recommended when instability is suspected or neurological symptoms are present. The first aim of treatment must be the relief or attenuation of pain, followed by improvement of the function. Immobilization of the cervical spine by means of a Schanz collar is rather detrimental. Varied vegetative symptoms require the involvement of different specialists in the treatment at an early stage. Expert assessment for insurance purposes is complicated because the consequences of the accident cannot be objectified, and expecially because the insurance companies require differentiation between the degenerative changes that were present before the injury was sustained in many cases and the symptoms actually caused by the injury.