1. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Crippling Upper Back Pain After Whiplash and Other Motor Vehicle Collisions Caused by Thoracic Disc Herniations: Report of 10 Cases Erwin M. J. Cornips, MD Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands

2. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Motor vehicle collision victims often report persisting, crippling upper back pain 4 patterns of pain determining most variance in pain localization after motor vehicle collisions

3. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Posttraumatic upper back pain – often regarded as aspecific related to a whiplash injury to the neck – may be caused by a thoracic disc herniation preexisting may be calcified may be accompanied by myelomalacia may have been previously asymptomatic

4. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Exact pathophysiological mechanism of thoracic disc herniation related pain – essentially unknown – likely multifactorial mechanical(cord compression) ischemic (venous congestion) inflammation trauma(catalyzator)

5. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Results after adequate cord decompression through thoracoscopic microdiscectomy are encouraging Clinicians dealing with motor vehicle collisions (including whiplash injuries) should be aware of this previously unknown association