Thoracic Spine Extension Injuries in Occupants with Pre-Existing Conditions during Rear-End Collisions
Certain ankylosing spondyloarthropathies such as ankylosing spondylitis (AS) or diffuse idiopathic skeletal hyperostosis (DISH) can substantially alter clinicopathologic spine biomechanics as well as injury mechanisms in rear-end motor vehicle collisions. AS is an inflammatory disease which can lead to structural impairments of the spine secondary to flowing ossification along the spinal column, including ossification across the spinal discs, facet joints, and ligaments, and it has also been associated with diffuse osteoporosis of the spine. DISH is characterized by excess bone formation along the spinal column, encompassing the annulus and forming the thickest and strongest bridging osteophytes over adjacent vertebral bodies at the level of the disc space. In both conditions the spine is mechanically stiffened and generally more kyphotic than a healthy spine.