• Eva McCabe, Mutaz Jadaan, Dima Jadaan, and John P McCabe.
• School of Medicine, National University of Ireland, Galway, Ireland. e.mccabe2@nuigalway.ie.
• Ir J Med Sci. 2020 Feb 1; 189 (1): 211-217.

BackgroundWhiplash injuries result from an acceleration-deceleration injury of the cervical spine. The associated symptoms may include neck pain/stiffness; cervicogenic headaches; interscapular pain; upper limb pain, paraesthesia and weakness. Current treatment protocols recommend conservative management of low-grade whiplash.AimsTo assess changing practices over time in the management of whiplash-associated disorders in the practice of a specialist spine surgeon and to explore the impact of associated litigation on this patient cohort.Methods And ResultsThe private medical records of a specialist spine surgeon over a 15-year period (1996-2011) were reviewed. Three hundred one consecutive patients were identified: 169 females and 132 males with a mean age of 37 years ± 13. All were referred by primary care with potential soft tissue injury of the cervical spine following a road traffic accident. Fifty-eight percent had associated back pain. An initial conservative approach was adopted in all cases. Subsequently, 4 patients underwent surgical intervention. Ninety-three percent reported chronic neck pain > 6 months after their injury. Age was the only significant predictor of chronic neck pain (adjusted OR 1.29 for every 5-year increase, p = 0.03). All were ultimately involved in litigation. The establishment of the Personal Injuries Board did not influence the litigation duration during the study period.ConclusionWhiplash poses a significant societal economic burden in Ireland and was associated with prolonged symptoms including neck pain and upper limb neuropathic symptoms in this cohort. Associated low-back pain was common. Litigation was linked with presentation in all cases.

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