Morphology of Cervical Spine Meniscoids in Individuals With Chronic Whiplash Associated Disorder: A Case-Control Study

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Farrell, Scott F
Osmotherly, Peter G
Cornwall, Jon
Lau, Peter
Rivett, Darren A
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2016
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Abstract

Study Design: Case-control study.

Background: Cervical spine meniscoids are thought to contribute to neck pain and hypomobility in individuals with chronic whiplash-associated disorder (WAD); however, their morphology has not been studied in a clinical population.

Objectives: To investigate cervical spine meniscoid morphology in individuals with chronic WAD.

Methods: Twenty volunteers with chronic WAD (mean ± SD age, 39.3 ± 11.0 years; 10 female) and 20 age- and sex-matched controls (age, 39.1 ± 10.6 years) underwent cervical spine magnetic resonance imaging. Lateral atlantoaxial and zygapophyseal joints (C2–3 to C6–7) were inspected for meniscoids. Length of meniscoid protrusion was measured and composition (adipose/fibrous/fibroadipose) assessed. Data were analyzed using Wilcoxon signed-rank tests and linear and logistic regression (P<.05).

Results: Meniscoids were identified in the chronic WAD (n = 317) and control (n = 296) groups. At the lateral atlantoaxial joints, median meniscoid length was greater in the control group (ventral, 6.07 mm; dorsal, 7.24 mm) than the WAD group (ventral, 5.01 mm; P = .06 and dorsal, 6.48 mm; P<.01). At the dorsal aspect of zygapophyseal joints, meniscoids were more frequently fibrous in the chronic WAD group (odds ratio = 2.38, P<.01; likelihood ratio test: χ22, 9.02; P = .01).

Conclusion: In individuals with chronic WAD, lateral atlantoaxial meniscoids were shorter and dorsal cervical zygapophyseal meniscoids were more fibrous, suggesting alterations in meniscoid composition. This may have pathoanatomical implications in chronic WAD.

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Journal of Orthopaedic & Sports Physical Therapy

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46

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10

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Clinical sciences

Clinical sciences not elsewhere classified

Sports science and exercise

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