Effect of head restraint backset on head–neck kinematics in whiplash

Although head restraints were introduced in the 1960s as a countermeasure for whiplash, their limited effectiveness has been attributed to incorrect positioning. The effect of backset on cervical segmental angulations, which were previously correlated with spinal injury, has not been delineated. Therefore, the practical restraint position to minimize injury remains unclear. A parametric study of increasing head restraint backset between 0 and 140 mm was conducted using a comprehensively validated computational model. Head retraction values increased with increasing backset, reaching a maximum value of 53.5 mm for backsets greater than 60 mm. Segmental angulation magnitudes, greatest at levels C5–C6 and C6–C7, reached maximum values during the retraction phase and increased with increasing backset. Results were compared to a previously published head restraint rating system, wherein lower cervical extension magnitudes from this study exceeded mean physiologic limits for restraint positions rated good, acceptable, marginal, and poor. As head restraint contact was the limiting factor in head retraction and segmental angulations, the present study indicates that minimizing whiplash injury may be accomplished by limiting head restraint backset to less than 60 mm either passively or actively after impact.