TDHs (Thoracic disc herniations) have a variable presentations and can mimic other diseases and many are misdiagnosed because of this. A TDH is thought be relatively rare compared to cervical or lumbar herniation. A traumatic origin has been estimated in up to 25 per cent of TDHs.
Whiplash injury has an estimated occurrence of 300 per 100,000 adults in western countries and is associated with pain, disability and cost. The symptoms of whiplash injury vary widely and can range from mild to severe but in most patients no specific pathology is identified.
In this study, 10 patients were found to have severe upper back pain after a motor vehicle collision (MVC) and a TDH at the level of pain. The study demonstrates that pain caused by TDHs may be relieved by surgical decompression.
All 10 patients underwent thoracoscopic microdisectomy. At one year after the operation results were excellent in seven, good in two and poor in one. One year after the operation, four patients returned to full time work, from being unable to work; two patients increased their hours at work; one did not return to work due to another medical issue but reported an excellent surgical outcome; the final patient had a poor outcome and the reason for her persisting pain remains obscure.
Many people that have MVCs have persistent pain that is difficult to diagnose and regarded as nonspecific. This study has found that some of MVC victims experience a TDH. The TDH may have been present before the accident without causing symptoms but accident triggered symptoms.