SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2013
Magnetic resonance imaging signal changes of alar and transverse ligaments not correlated with whiplash-associated disorders: a meta-analysis of case-control studies.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Factors predicting outcome in whiplash injury: a systematic meta-review of prognostic factors.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2017Pooled it
- Initial Head Posture Affects the Neck Muscle and Head/Neck Kinematic Responses During Low-Speed Rear Impacts.Annals of biomedical engineering · 2026Article
- Biological Markers of Brain Network Connectivity and Pain Sensitivity Distinguish Low Coping from High Coping Veterans with Persistent Post-Traumatic Headache.Journal of neurotrauma · 2025Observational
- Whiplash-associated injuries in medicolegal contexts: a review of imaging findings and a pictorial essay.Neuroradiology · 2025Review
- Imaging and classifications of atlantoaxial dislocation: a narrative review.EFORT open reviews · 2025Review
- [Atlas block and alar ligament lesion-Underestimated or overrated?]Schmerz (Berlin, Germany) · 2024Review
- Demonstration of transverse ligament on 3D SPACE MRI in whiplash-associated disorder and nontraumatic conditions.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- The nosological classification of whiplash-associated disorder: a narrative review.The Journal of the Canadian Chiropractic Association · 2021Article
- Article
- Inter-examiner reliability of radiographic measurements from Open-mouth lateral bending cervical radiographs.Chiropractic & manual therapies · 2020Article
- Age-related changes to the craniocervical ligaments in asymptomatic subjects: a prospective MR study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Article
- Article
- Diagnostic accuracy and validity of three manual examination tests to identify alar ligament lesions: results of a blinded case-control study.The Journal of manual & manipulative therapy · 2019Article
- Intramuscular fat is present in cervical multifidus but not soleus in patients with chronic whiplash associated disorders.PloS one · 2018Article
- Predicting nonrecovery among whiplash patients in the emergency room and in an insurance company setting.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2017Article
- An Attempt of Early Detection of Poor Outcome after Whiplash.Frontiers in neurology · 2016Article
- [Expert evidence in whiplash injury: interdisciplinary orthopaedic and biomechanical approach].Der Unfallchirurg · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHypothesis that loss of integrity of the membranes in the craniocervical junction might be the cause of neck pain in patients with whiplash-associated disorders (WADs) has been proposed. In recent years, with development of more detailed magnetic resonance imaging (MRI) techniques, morphologic changes of the ligaments and membranes in the craniocervical junction, especially alar and transverse ligaments have been discussed. A meta-analysis was performed to evaluate the relationship of MRI signal changes of alar and transverse ligaments and WADs.
methodsA systematic search of EMBASE, PUBMED, and Cochrane Library and references from eligible articles were conducted. Comparative studies reporting on evaluating the relationship between MRI high-signal changes of alar and transverse ligaments and WADs were regarded eligible. A pooled estimate of effect size was produced.
resultsAlar ligaments: Six studies (total n = 622) were included. MRI signal changes of alar ligaments did not appear to be related with WADs (P = 0.20, OR = 1.54, 95 % CI = 0.80-2.94). Heterogeneity was present (I (2) = 46 %, P = 0.10), which was eliminated upon sensitivity analysis bringing the OR to 1.27 (95 % CI = 0.87-1.86, I (2) = 0 %). Transverse ligaments: Four studies (total n = 489) were included. MRI signal changes of transverse ligament did not appear to be related with WADs (P = 0.51, OR = 1.44, 95 % CI = 0.49-4.21). Heterogeneity was present (I (2) = 77 %, P = 0.005), which was eliminated upon sensitivity analysis bringing the OR to 0.79 (95 % CI = 0.49-1.28, I (2) = 0 %).
conclusionMRI signal changes of alar and transverse ligaments are not supposed to be caused by whiplash injury, and MRI examination of alar and transverse ligaments should not be used as the routine workup of patients with WADs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.