Whiplash Surgery: When it’s Necessary

Whiplash injuries very rarely call for surgery. But with those rare occurrences, that are severe cases, surgery is considered appropriate when neck or shoulder pain worsens. Doctors recommend patients go through 4 to 6 weeks of non-surgical treatment. If there is no improvement or the condition is worsening then a doctor could recommend whiplash surgery as the best option. A spine surgeon will recommend the best procedure for the specific injury. Ask all the questions you have to fully understand the exact process, the outcome, and the recovery time. Surgery is an individual’s decision. The surgeon can recommend it, but the patient has the final say. The procedure depends on what area/s the cervical spine is injured/damaged.  

Disc Herniation

Depending on the type of trauma individuals can rupture or herniate the intervertebral disc/s, located between the vertebrae. This can generate constant pain, numbness, and weakness. With cases like this sometimes removal of the disc is necessary.   A surgeon will remove all or portion of the damaged disc through a process called a discectomy. After the discectomy, a doctor may have to permanently stabilize the area. This is because the spine becomes unstable and can move in abnormal ways. This increases the risk of a serious neurological injury. Therefore a discectomy is usually followed with a re-stabilization of the spine. Spinal stabilization techniques used:

Artificial Disc Replacement

Cervical artificial disc replacement also known as ADR could be performed instead of standard discectomy combined with spinal fusion. An artificial disc is implanted into the empty space following the procedure. Artificial disc replacement preserves or restores movement of the neck.

Fusion and Spinal Instrumentation

This form of spine stabilization can be done on its own or in combination with decompression surgery. The bones in the spine fuse together over time usually several months or longer depending on how the surgeon set up the fusion process. The surgeon will use a bone graft or a biological chemical that stimulates bone growth. A surgeon could use spinal instrumentation. These are:

• Interbody device/s
• Screws
• Rods
• Plates

These all are used to increase stability and help fuse the bones properly. The fusion prohibits movement between the vertebrae for long-term stability.

Stenosis

Whiplash surgery could also be necessary if the injury caused the spinal canal in the neck to narrow. Here a cervical corpectomy could be performed to remove part of the vertebra and intervertebral disc/s. This reduces the added pressure on the spinal cord and nerves. A surgeon could also do a laminectomy or a laminoplasty. Both focus on the lamina, which is the bony plate at the back of each vertebra. The lamina protects the spinal cord and canal. The lamina could also present added pressure on the spinal cord. This is where the surgeon will create extra space for the cord by removing all or part of the lamina. This is a laminectomy.   A laminoplasty re-shapes the lamina to create more room for the spinal cord. If there is a narrowing of the space where the nerve exits the canal, a cervical foraminotomy could be utilized. The foramen is the area where the nerve roots exit the spinal canal. This is removed to allow for more space for the nerves to move through. A larger pathway is less likely to pinch/compress the nerve.

Complications

A doctor will discuss all the potential risks before being asked to sign a surgical consent form. Complications can include:

• Injury to the spinal cord, nerves, esophagus, carotid artery, vocal cords
• The bone fusion does not heal known as pseudoarthrosis
• Improvement does not occur
• Instrumentation breaks or gets damaged
• Infection
• Bone graft site pain
• Pain and swelling in the leg veins known as phlebitis
• Blood clots in the lung
• Urination problems

Complications could lead to more surgery, so make sure there is a complete understanding of the surgery and the risks before proceeding. The final decision is up to the individual.

Whiplash Surgery Recovery

After surgery, things might not be great right away. More than likely individuals are out of bed within 24 hours, and on pain meds for 2 to 4 weeks. Individuals will receive instructions on how to sitting down, and standing up. The body needs time to heal, so the doctor will recommend restricting certain activities that involve moving the neck too much. Avoid sports, twisting, or heavy lifting during recovery. And report any problems like fever increased pain, or infection right away.

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Whiplash Chiropractic Rehabilitation

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