%0 Journal Article
%T Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve; results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash syndrome
%A N Ake Nystrom
%A Lloyd P Champagne
%A Michael Freeman
%A Elisabet Blix
%J Journal of Brachial Plexus and Peripheral Nerve Injury
%D 2010
%I Thieme Medical Publishers
%R 10.1186/1749-7221-5-7
%X A standardized questionnaire and a linear visual-analogue scale graded 0-10 was used to assess disability related to five symptoms (pain, headache, insomnia, weakness, and stiffness) before, and one year after surgery in a series of thirty consecutive patients.The preoperative duration of symptoms ranged from seven months to 13 years. The following changes in disability scores were documented one year after surgery: Overall pain decreased from 9.5 +/- 0.9 to 3.2 +/- 2.6 (p < 0.001); headaches from 8.2 +/- 2.9 to 2.3 +/- 2.8 (p < 0.001); insomnia from 7.5 +/- 2.4 to 3.8 +/- 2.8 (p < 0.001); weakness from 7.6 +/- 2.6 to 3.6 +/- 2.8 (p < 0.001); and stiffness from 7.0 +/- 3.2 to 2.6 +/- 2.7 (p < 0.001).Entrapment of the spinal accessory nerve and/or chronic compartment syndrome of the trapezius muscle may cause chronic debilitating pain after whiplash trauma, without radiological or electrodiagnostic evidence of injury. In such cases, surgical treatment may provide lasting relief.Among patients who develop permanent debilitating symptoms after whiplash trauma (referred to as chronic whiplash syndrome henceforth), headaches and/or pain and stiffness in the neck and shoulder are the most frequent complaints and reasons for disability [1-3]. In addition, complex patterns of diffuse symptoms, including numbness, paresthesias, vertigo, muscle weakness, or cognitive dysfunction, are common and have been shown to correlate with post traumatic sleep deprivation [4] or brain stem dysfunction [5-7]. Yet, many patients claim disability in spite of normal findings on standard laboratory tests. This has led to controversy in the literature as some authors argue that symptoms are credible only if corroborated by laboratory findings [8] while others claim that negative studies do not exclude injury or the validity of a complaint [9,10].Chronic symptoms from whiplash trauma have commonly been linked to pathology of the spine and its supporting tissues, i.e. facet joints [11], spinal l
%U http://www.jbppni.com/content/5/1/7