Clinical definition of whiplash

In the present study, all subjects with lesions classified as cervical contusion (AIS code 310402) or neck sprain (AIS code 640278) were considered as whiplash casualties. Diagnosis was made by physicians, at the outset of hospital care, based on interview, clinical findings and X-ray. In the AIS classification, Code 310402 is attributed to neck pain following a road accident with painful neck on palpation without other objective signs, and corresponds to grade 1 in the Quebec classification; Code 640278 is attributed to neck pain associated with cervical stiffness and radiologic loss of cervical lordosis, and corresponds to grade 2 in the Quebec classification [23]. Cervical spine lesions graded AIS-1 (code 640278) but with associated neurologic abnormality (Quebec grade 3) (n = 2) were excluded.