# Improvement in Cervical Spinal Alignment and Posture May Redefine Recovery Pathways for Motor Vehicle Collision Whiplash Injury: A Multicenter Retrospective Consecutive Case Series

## TL;DR

This study shows that spinal rehabilitation using Chiropractic BioPhysics improves posture and neck pain in severe whiplash injuries after initial recovery plateaus.

## Contribution

Demonstrates CBP® can improve outcomes in MVC whiplash patients with little-to-no recovery after 3-4 months.

## Key findings

- CBP® treatment improved cervical curvature from -10.3° to -22.5° and reduced anterior head translation from 28.5 mm to 15.9 mm.
- Neck pain and disability scores improved significantly from severe to minimal levels after treatment.
- Improvements occurred in patients who showed little-to-no recovery after 3-4 months of standard care.

## Abstract

Background/Objectives: Motor vehicle collision (MVC) cervical acceleration–deceleration (CAD) spine injuries are prevalent, costly, and complicated conditions. CAD injuries, or whiplash-associated disorders (WAD), present with neuromusculoskeletal signs and symptoms. In total, 50% of MVC WAD/CAD injuries result in chronic neck-related disability, of which 30% are moderate-to-severe. Poor recovery is associated with little-to-no recovery after 3 months. This study reports on health outcomes of patients with MVC/CAD injuries treated with Chiropractic BioPhysics® (CBP®) spinal rehabilitation beyond little-to-no recovery in neck pain (NP) and disability after 3-to-4 months. Methods: This multicenter retrospective consecutive series reports on patients who met inclusion/exclusion criteria from a records review from two private practices with advanced training in CBP®. Results: In total, 51 patients (26 males), 18–74 years-of-age (mean age 42.8 ± 3.6 years), presented with post-MVC NP and disability. Pre-treatment radiographs revealed decreased cervical curvature (ARA C2-C7) measuring −10.3 ± 2.0° (ideal is −42.0°) and anterior head translation (Tz C2-C7) measuring 28.5 ± 2.0 mm (ideal is 0 mm). The pre-treatment NP numeric rating scale (NRS) scored 6.0 ± 1.0, and the neck disability index (NDI) scored 54.3 ± 9.3% (severe). Patients were treated using CBP® for 64.5 ± 4.7 visits over 31.6 ± 3.7 weeks. Post-treatment radiographs revealed an improved ARA C2-C7 to −22.5 ± 2.3° and Tz C2-C7 to 15.9 ± 1.6 mm (p < 0.001). Subsequent 3-to-4-month re-exam showed little-to-no change in NP and disability outcomes. Post-treatment outcomes at a mean 18.5 weeks after the 3-to-4-month re-exam showed significant (p < 0.001) improvements in NP NRS to 1.1 ± 0.7 and NDI to 6.8 ± 5.5 (minimal). Conclusions: CBP® improves cervical lordosis and posture, which may help improve moderate-to-severe WAD/CAD spine injuries beyond 3-to-4 months of little-to-no recovery.