Question
I have gotten a whiplash few times in the past through fender benders and falling. I recently fell and sustained hairline fracture of my thoracic one vertebrae. what are the signs and symptoms of the disc herniation?? how come some cases require surgery and others don't?? since I have to wear a cervical collar how long should I wear it for?? What is the signicance of your c6 c7 and t1??

Answer
Hi Nicole,

Sorry to hear about your fall.

Regarding disc herniation, T1 is rare, but should be visible on MRI. The signs and symptoms will vary, however, there are general signs and symptoms. For the first thoracic vertebra, T1, you can have arm pain, numbness and/or tingling on the little finger side of the arm around the elbow and a bit above or below. With C6 & 7, you can experience these symptoms on the thumb side of the arm and into the thumb and first 2 fingers. With C6 & 7 there may be reduced or absent reflexes upon examination, along with weakness of the biceps, triceps and with bending the wrist. With a T1 disc herniation, there may be symptoms along the last 2 fingers and weakness of the fingers or hand muscles, like grasping something.

With a disc problem, there may be increased pain with straining as with holding your breath and lifting, coughing or straining to use the bathroom. If this is the case, make sure you use a good laxative to avoid straining, as many medications for pain can cause constipation. You may find increased pain if someone places pressure on top of your head or bending and tilting your head to one side. There may be relief when raising on arm or if someone lifts your head upward slightly.

I'm not sure exactly where the hairline fracture is, however, this is a weak point and needs to heal. Wearing a collar for 6 to 8 weeks is reasonable. Sometimes longer or shorter depending on the extent and location of the fracture, but avoiding further injury is very important. With a fracture and herniations, this may take a bit longer to heal, but once the fracture is healed, you should not have to wear the collar.

Regarding surgery, this is usually a last resort. Sometimes, there can be problems with it effecting the spinal cord and having symptoms extend into the legs. This can be an indication for surgery along with severe levels of pain that do not respond to treatment. However, most cases will heal with standard or conservative treatment. If it does not improve over a reasonable time and does not respond to conservative therapies or injections, surgery may be indicated. Since it is a hairline fracture and the herniations are mild, there should not be any complications.

I hope this helps and that you have a speedy and complete recovery.

Kind Regards,

Dr. Steve