Neck Solutions

Neither the Whiplash Associated Disorders classification nor the Quebec Task Force follow-up regimen seems to be important for the outcome after a whiplash injury.

From: Eur Spine J. 2008 Apr 22; [Epub ahead of print]

A classification of injury and a follow up schedule were proposed by the Quebec Task Force in 1995. No general agreement about the clinical usefulness of the Whiplash Associated Disorders classification or of the suggested follow up regimen exists. A series of 186 consecutive cases seen in the emergency room during the acute phase after a whiplash injury was prospectively studied for 1 year. All findings including history and physical findings were recorded using standardized Quebec Task Force protocols. In one group follow up visits were done according to the Quebec Task Force regimen: at 1, 3, 6, 12 weeks and 1 year after the accident; in a control group no visit was scheduled. The outcome variable was neck pain at 1 year after the accident. After 1 year, 18% of the total number of patients had significant neck pain. Risk factors for chronic neck pain at 1 year after whiplash injury were: neck pain before the accident and a high degree of emotional distress at the time of the accident; both factors independently associated with a tenfold increased risk of developing chronic neck pain. Neither the Whiplash Associated Disorders classification nor the Quebec Task Force follow-up regimen could be linked to a better outcome. In this study the outcome was associated with patient specific characteristics and not with physical signs of injury, the depth of the initial evaluation or the follow-up regimen.