Mortality from traumatic spinal cord injury is up to 6.18%.[8]Yadollahi M, Paydar S, Ghaem H, et al. Epidemiology of cervical spine fractures. Trauma Mon. 2016 Jul;21(3):e33608.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5124335
http://www.ncbi.nlm.nih.gov/pubmed/27921020?tool=bestpractice.com
Patients with ankylosing spondylitis are at particularly high risk of complications and death following spinal injuries.[22]Caron T, Bransford R, Nguyen Q, et al. Spine fractures in patients with ankylosing spinal disorders. Spine (Phila Pa 1976). 2010 May 15;35(11):E458-64.
http://www.ncbi.nlm.nih.gov/pubmed/20421858?tool=bestpractice.com
Most patients with simple neck sprain injury (i.e., injury to the neck where there has been no demonstrable bony injury or unstable ligamentous injury) or whiplash will recover completely in a matter of days to weeks. Approximately one third of patients will experience persistent symptoms, often in the absence of readily observed pathology (such as disc herniation). A history of neck injury in motor vehicle collision is a risk factor for developing future neck pain.[37]Nolet PS, Côté P, Cassidy JD, et al. The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study. Eur Spine J. 2010 Jun;19(6):972-81.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899973
http://www.ncbi.nlm.nih.gov/pubmed/20213298?tool=bestpractice.com
Patients with a prior whiplash injury, or with pre-existing neck or head pain, have been found to have a poorer prognosis after a second injury.[20]Khan S, Bannister G, Gargan M, et al. Prognosis following a second whiplash injury. Injury. 2000 May;31(4):249-51.
http://www.ncbi.nlm.nih.gov/pubmed/10719104?tool=bestpractice.com
[38]Walton DM, Macdermid JC, Giorgianni AA, et al. Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013 Feb;43(2):31-43.
https://www.jospt.org/doi/10.2519/jospt.2013.4507
http://www.ncbi.nlm.nih.gov/pubmed/23322093?tool=bestpractice.com
Recovery is highly variable, and it is difficult to determine which patients will be least likely to recover within the first 3 months of injury.[39]Tomlinson PJ, Gargan MF, Bannister GC. The fluctuation in recovery following whiplash injury 7.5-year prospective review. Injury. 2005 Jun;36(6):758-61
http://www.ncbi.nlm.nih.gov/pubmed/15910829?tool=bestpractice.com
There are no validated algorithms for predicting poor recovery from whiplash injury,[40]Daenen L, Nijs J, Raadsen B, et al. Cervical motor dysfunction and its predictive value for long-term recovery in patients with acute whiplash-associated disorders: a systematic review. J Rehabil Med. 2013 Feb;45(2):113-22.
http://www.medicaljournals.se/jrm/content/?doi=10.2340/16501977-1091&html=1
http://www.ncbi.nlm.nih.gov/pubmed/23307298?tool=bestpractice.com
although there is some indication that patients who experience upper extremity radiculopathy and an early decrease in global pain thresholds (central nervous system sensitisation signs) are more likely to have persistent pain.[41]Karnezis IA, Drosos GI, Kazakos KI. Factors affecting the timing of recovery from whiplash neck injuries: study of a cohort of 134 patients pursuing litigation. Arch Orthop Trauma Surg. 2007 Oct;127(8):633-6.
http://www.ncbi.nlm.nih.gov/pubmed/17487496?tool=bestpractice.com
[42]Sterling M, Jull G, Vicenzino B, et al. Sensory hypersensitivity occurs soon after whiplash injury and is associated with poor recovery. Pain. 2003 Aug;104(3):509-17.
http://www.ncbi.nlm.nih.gov/pubmed/12927623?tool=bestpractice.com