A whiplash injury is a non-medical term to describe a range of neck injuries that occur with a sudden distortion of the neck. A whiplash injury is commonly the result of a motor vehicle accident. The most common scenario is that the victim is seated in a vehicle that is rear ended or hit from the rear quarter. A whiplash injury can occur at speeds less than 15 miles per hour Los Angeles Back.
Patients will typically experience pain along the neck, corresponding to the level of where the pain is being generated from. Neck pain due to whiplash injury can be immediate or can progress over several weeks. Neck pain may be referred to the shoulders, upper back or may even sometimes cause headache. A whiplash injury may result in stretching or pinching of the spinal nerves. With involvement of the nerves, radiating pain may be present to the shoulder, arm or fingers Endoscopic spine surgery.
The biomechanics of whiplash injury are well studied. At impact there is a violent and complex multi- stage movement of the neck. First, the lower spine extends while the rest of the spine flexes, resulting in an S shaped configuration of the spine. Then, the upper spine starts to extend, as the lower spine already has. This causes an extreme rotational torque at the lower spine. This torque causes the joints of the lower spine to impact on one another, injuring the spinal joints, called facet joints. Spinal ligaments and discs can also be injured due to whiplash. Neck pain can become chronic in 10% to 40% of sufferers Minimally invasive spine surgery.
The diagnosis of a whiplash injury can be made by a careful history. The mechanism of injury and pain symptoms are the leading clues. MRI will often fail to show acute injury to the facets joints, although MRI is effective in detecting disc herniation or ligament injury due to whiplash. In chronic injury, x-rays and MRI can show neck joint degeneration.
Medications and therapy are the first line in the treatment of a whiplash injury. In patients that don’t respond a spinal pain management evaluation can be performed. In this highly specialized evaluation, we determine which of the structures in the neck the pain is emanating from. Spinal injections can bring relief and confirm the source of pain. Minimally invasive surgery is reserved only for cases that do not improve with spinal injections.
An epidural steroid injection is used to treat pain arising from irritation of spinal nerves and discs. Steroid medications, designed to reduce inflammation, are injected into the epidural space. The epidural space is a space in the spine superficial to the spinal cord where spinal nerves travel.
In 2012 there was an outbreak of meningitis caused by contaminated steroids. All cases came from facilities that used medications that were mixed in an unclean environment. The Los Angeles Minimally invasive Spine Institute only uses medications that are mixed in the operating room under clean and sterile conditions at the time of injection.
The physician places a small needle through the skin of the lower neck and through a natural opening in the bones of the spine. The needle then is directed into the epidural space where spinal nerves travel. A small amount of x-ray dye shows the doctor that the needle is in the correct location. The injection consists of medications that reduce inflammation and pain.
Allow yourself an hour to be prepared for the procedure. The actual procedure will take about 15 to 30 minutes. After the procedure you will recover for 30 minutes to an hour before going home.
You can generally return to your normal activities by the next day. You can shower the same day as the procedure.
Percutaneous means surgery is performed through a needle puncture, instead of a large skin incision. The use of a needle allows the surgeon to access the disc through a tiny opening in the skin and through natural openings in the spine. Once the needle is in place it is exchanged for a small tube that allows an endoscope to pass through it. Endoscopic means that the surgeon performs the procedure through a channel in the endoscope, while watching with the endoscope camera.
Percutaneous cervical discectomy is a minimally invasive procedure for the treatment of neck pain or cervical nerve pain due to a herniated disk. To start the procedure, a tiny skin nick is made on the skin at the front of the neck. A needle is placed through the skin nick and into the disc. A small wire is then placed into the disc, through the needle. The needle is exchanged for a series of small tubes. Using specialized instruments surgery is performed through these tubes. The procedure is guided by an endoscope, placed through the tube, and x-rays.