Lumbar Intervertebral Disc Injuries in Low Velocity Rear End Vehicular Collisions: The Current Evidence

Rear-end collisions are the most frequently occurring type of collision in the United States, accounting for approximately 29% of all collisions. Of these collisions, many are so- called “low velocity” or “minimal impact” type collisions, characterized by low impact speeds (less than 9-10 mph) and limited observable damage to the rearended vehicle. Lumbar intervertebral disc injuries are sometimes claimed by injured parties as a result of such collisions. This paper addresses lumbar biomechanics and relevant topics, such as degeneration and potential injury mechanisms, with a focus of how such knowledge relates to the occurrence of lumbar intervertebral disc injuries as a result of low velocity rear-end impacts. We conclude that the evidence for the occurrence for lumbar disc injuries in such collisions is not compelling, reflecting limited impact forces, limited lumbar range of motion, and the general lack of injury mechanisms being present. However, it is acknowledged there are significant data gaps. Important questions needing further inquiry include the experimental validation of the concept that acute disc injuries can occur at all under such conditions and the role of degenerative processes.