Compressive tolerance of the maturing cervical spine

Stapp Car Crash J. 2002 Nov;46:431-40. doi: 10.4271/2002-22-0021.


While a number of experiments have reported injury thresholds for the adult cervical spine in compression, the compressive failure tolerance of the child spine has not been characterized. In order to develop useful safety measures for children, the biomechanical effects of maturation must be evaluated. Hence, this study examined the effects of spinal development on the compressive mechanics of the cervical spine. An animal model was used due to the lack of human tissues in the pediatric age range. Twenty-two fresh cadaveric baboon cervical spines (all male) were dissected into two functional spinal unit segments: Occiput-C2, C3-C5, C6-T1. The specimens ranged in age from 1 to 30-human equivalent years based upon radiographic assessment of their skeletal maturity. Dynamic (1.0-m/sec) haversine displacement inputs up to 70% strain were imparted on each specimen and the resulting loads were recorded. Significant increases in the compressive failure load were observed with increased maturation of the spinal tissues (ANOVA, p = 0.003). Differences were also observed between the spinal levels examined. The lower cervical spine, C6-T1, had the smallest failure load for specimens greater than 8-human-equivalent years, while the upper cervical spine was the most susceptible to injury at less than 8-human-equivalent years. The compressive failures generated are consistent with those observed clinically, consisting of primarily burst fractures and physis (growth plate) failures. These data clearly suggest that spinal compressive tolerance is directly related to maturation. Therefore, through scaling, these data may provide tolerance values applicable to anthropomorphic test dummies and computational models aimed at injury prevention for the pediatric occupant.