Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 84. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | 828 Section Fractures Personal societal and environmental factors appear to playa role WAD tends to become chronic lash . compensated claims and the country the incidence may vary largely 143 175 181 184 . In Canada regional differences in jurisdiction resulted in a range of reported treated injuries from 70 Quebec to approximately 600 Saskatchewan per 100000 inhabitants 107 . The incidence and prognosis of whiplash injury from motor vehicle collisions is related to eligibility for compensation for pain and suffering as shown by Cassidy et al. 44 . Changing the policy from a tort system to a no-fault system resulted in a decrease of the 6-month cumulative incidence of claims from 417 to about 300 per 100000 persons 44 . In the Netherlands the incidence substantially increased from 55 1970-1974 to 241 1990-1994 per 100000 inhabitants 200 201 . Although it seems that females are at slightly greater risk the evidence that gender is associated with risk of WAD is inconsistent 107 . Younger patients appear to have a slightly higher risk of WAD 107 . Preliminary evidence indicates that headrests car seats which aim to limit head extension during a rear-end collision have a preventive effect on WAD reporting 107 . The evidence regarding risk factors for WAD is sparse but appears to include personal societal and environmental factors 107 . The rate of patients reporting persistent pain restriction of motion or other symptoms at 6 months or more after a whiplash injury late whiplash syndrome 184 sufficient to hinder return to normal activities such as driving normal occupational and leisure activities ranges between 1 and 71 52 175 207 . However it appears from the literature that there is a strong tendency for WAD to become chronic with about 50 of patients having symptoms one year after the injury 43 . Greater initial pain more symptoms and greater initial disability appear to predict slower recovery. Postinjury psychological factors such as passive coping style .
