Treatment for Refractory Whiplash Injury: Traumatic Thoracic Outlet Syndrome

"Whiplash" is a common injury in clinical management, but occasionally patients do not respond to conventional treatment, and become worse instead. We have noted that these severe symptoms represent the classic features of thoracic outlet syndrome (TOS) in the past 10 years. Sixty-four patients were reviewed as neurogenic traumatic TOS (T-group), and 17 patients as TOS associated with cervical disc disease (CT-group) . During treatment, we in itially provided all T-group cases with an explanation of traumatic TOS. Therapeutic muscle toning exercise or use of shoulder-girdle and cervical spine pillow are highly desirable. Use of medication or neck colar, and certain injections are also recommended for CT group cases. Anterior cervical fusion was performed on six patients with CT suffering neck or arm pain related to cervical radiculopathy. All six cases of disc injury displayed chronic residual symptoms after anterior fusion, and underwent additional therapies over an average of 548 days. The long period of convalescence, financial loss through disability, and inevitable medical-legal complications make TTOS one of the most prevalent and important posttraumatic problems faced by medical professionals.