Traumatischer zervikaler Bandscheibenvorfall nach Niedriggeschwindigkeitsunfall?

Abstract

Abstract Background Generally, disc changes are of degenerative origin and develop over a longer time span. Accidental incidents with isolated traumatic disc ruptures are rare events; however, occupants involved in low velocity accidents often claim a causal relationship between disc changes and accidents. In forensic casework the adequacy of the biomechanical load to cause traumatic disc rupture has to be assessed. Objective Based on patient data we addressed the following issues: – Do traumatic cervical disc rupture occur in low velocity accidents? – Are there always accompanying injuries in neuroradiological imaging? – What are the main injury mechanisms? Methods In this study we analyzed cases of traumatic disc ruptures without other severe injuries in patients who underwent surgical treatment between 2010 and 2021. The purpose was to identify cases with traumatic disc ruptures following low velocity scenarios. The sample contained 16 cases with the main diagnosis of traumatic cervical disc rupture. Results Falls caused traumatic disc rupture in 14 of the cases, while traffic accidents caused disc injury in 2 cases only. Radiological signs of acute trauma as well as sensorimotor deficits or pain were present in every case. Of the patients six did not sustain accompanying fractures. In the majority of cases a hyperextension mechanism was assumed, even though an exact reconstruction of the load was not possible in every case. Conclusion This study renders traumatic genesis of a disc rupture highly unlikely in patients involved in low velocity scenarios. Medical imaging without accompanying injuries or signs of acute trauma, e.g., in terms of bleeding, bony or ligamentous lesions, supports a non-accidental cause of disc changes. Nevertheless, expert opinions require case by case evaluation taking account of patient-specific and case-specific conditions.