BackBone: Journal of the American College of Spine Surgery

Spinal pain that arises from motor vehicular trauma is challenging to the treating physician due to the wide spectrum of presenting symptoms and responses to treatment, including traumatic disc herniations.  The severity of injuries varies from patient to patient, with imaging often not strictly correlating to symptomatology.  However, with a systematic approach, including an understanding of the limitations of magnetic resonance imaging (MRI) and the role of cytokines and inflammatory mediators, the treatment and diagnosis from patients suffering from traumatic disc herniations can be improved^1,2.  Furthermore, evidence supports conservative management before escalation to more invasive procedures such as epidurals or surgery, specifically in uncomplicated spinal injury patients with no evidence of neural compromise warranting emergency surgery^3,4.   Should surgery be needed, mounting evidence supports intervention with minimally invasive discectomy for lumbar herniations and cervical disc arthroplasty for cervical herniations^5–8.