Introduction: Combat-related injuries from improvised explosive devices occur commonly to the lower extremity and spine. As the underbody blast impact loading traverses from the seat to pelvis to spine, energy transfer occurs through deformations of the combined pelvis-sacrum-lumbar spine complex, and the time factor plays a role in injury to any of these components. Previous studies have largely ignored the role of the time variable in injuries, injury mechanisms, and warfighter tolerance. The objective of this study is to relate the time or temporal factor using a multi-component, pelvis-sacrum-lumbar spinal column complex model.
Materials and methods: Intact pelvis-sacrum-spine specimens from pre-screened unembalmed human cadavers were prepared by fixing at the superior end of the lumbar spine, pelvis and abdominal contents were simulated, and a weight was added to the cranial end of the fixation to account for torso effective mass. Prepared specimens were placed on the platform of a custom vertical accelerator device and aligned in a seated soldier posture. An accelerometer was attached to the seat platen of the device to record the time duration to peak velocity. Radiographs and computed tomography images were used to document and associate injuries with time duration.
Results: The mean age, stature, weight, body mass index, and bone density of 12 male specimens were as follows: 65 ± 11 years, 1.8 ± 0.01 m, 83 ± 13 kg, 27 ± 5.0 kg/m2, and 114 ± 21 mg/cc. They were equally divided into short, medium, and long time durations: 4.8 ± 0.5, 16.3 ± 7.3, and 34.5 ± 7.5 ms. Most severe injuries associated with the short time duration were to pelvis, although they were to spine for the long time duration.
Conclusions: With adequate time for the underbody blast loading to traverse the pelvis-sacrum-spine complex, distal structures are spared while proximal/spine structures sustain severe/unstable injuries. The time factor may have implications in seat and/or seat structure design in future military vehicles to advance warfighter safety.
Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.