Neurogenic thoracic outlet syndrome in whiplash injury

A prospective study of 110 patients was carried out to determine the pathog enic significance of trauma to the upper body in the development of neural compressive irritation at the thoracic outlet. Twenty-nine patients were re viewed as cervical strain injuries (N group). 25 patients as probable neuro genic thoracic outlet syndrome (NTOS) (PT group), 39 patients as definite N TOS (T group), and 17 patients as NTOS associated with cervical disc diseas e (CD-T group). The time lapse between accident and diagnosis and the durat ion of treatment were significantly longer in T patients or CD-T patients t han those in the N group. Radiography of NTOS patients also showed a higher percentage of cervical pine-length/height ratio. Traumatic NTOS would sugg est two types related to direct damage of scalene muscles that included som e physical aspects of cervical disc disease. Pathogenesis provided a key to the resolution of more complex posttraumatic problems of whiplash injury.