The most frequent injury that we see as a result of a motor vehicle accident is spinal injuries. One of the things that is very important to know about spinal injuries is that your attorney needs to know the spine and the other injuries including the doctors, and the insurance companies lawyers.
Our attorneys have tried hundreds of these cases, we have had special meetings with many neurosurgeons and orthopedic spine surgeons in Buffalo, NY and we’ve educated ourselves on the nature and extent of injuries associated with the spine. Often times after an accident, people go to the hospital. If they have spinal injuries, they will take an X-ray. The X-ray is a diagnostic tool that is used to determine whether or not there’s been any bone injury, or injury to the spinal vertebrae themselves.
Most times we don’t see those types of injuries. At the hospital, individuals are typically provided with some medication, it may be a pain killer, maybe some muscle relaxant, then told to go home, ice it or heat it and then to call their primary doctors. The problem with X-rays are the areas in between the vertebrae are not depicted and those are the areas where we typically see the injuries.
The spine is made up of three major component parts: the cervical spine, which is at the top with Thoracic spine, in the middle which is where your ribs are attached and then lower spine, which is the lumbar spine. Behind there you will see the spinal cord running down. Until you get to L1 which is the first lumbar vertebrae, at that point the spinal cord actually stops and becomes a Cauda Equina that strays out.
If you’re involved in an accident, forget about the fact that there’s a personal injury case. You need to find out what’s wrong with you so twenty years from now you are not walking around like someone older. You have to find out what’s wrong with you and you only have a limited amount of time to do so. What we’re looking for is to see if there’s any damage to the area.
The disc is an interesting part of the body because it is non-vascular. It has a very minimal blood supply to it and is made of two components. The inside of the disc is called the nucleus pulpous, the outside of the disc is called the annulus. What we’re looking for is to see if that nucleus pulposus is pushing through out of the disc. Once it does that there are certain things that we have to look for that determines whether or not that disc is going to cause certain types of injuries and certain types of problems.
If we take a look at the side we would call this the sagittal view in an X-ray and MRI. There are these little fingers sticking out and there’s a hole that they’re going through, that hole is called the foramen. The Foramen is just a Latin term for the word window. It is a bony window that allows the nerve to come out of the spinal cord and run through the window.
What we need to find out is a couple of things. We need to know if that disc is either bulging or herniating, protruding or extruding. We want to know if that disc is pushing into that Foramen and shutting the window down.
If the disc is shutting the window down again and then impacts on the nerve, it causes what we call Foraminal Stenosis. It impinges on the nerve and when it impinges on the nerve it creates a thing called Radiculopathy.
People have heard of a sciatic pain; that is a form of Radiculopathy at a very specific nerve root L5-S1. But that can happen in any one of these nerve roots so if you have a c4 c5 c5 c6 Radiculopathy Foraminal compression, part of the arm will start going numb. Based on the symptoms, we can determine which of these nerves has been affected.
The other thing that could happen is spinal stenosis, now picture the disc pushing backwards as opposed to the side .If it’s pushing backwards it will shorten or narrow the canal that your spinal cord is running and it doesn’t cause Foraminal Stenosis but Spinal Stenosis.
If that happens you can get the same type of symptomatology (meaning you get extremity problems, clumsiness, problems into the legs, and Myelopathy which involves difficulty with urinating, and difficulty with thinking).
The chiropractors who are dealing with these types of injuries typically do Subluxations, which means these vertebrae can pop out of place. They will try to manipulate them to get them back into place and take the pressure off from those nerve roots. We see physical therapists to try to build up the musculature around the area, we see neurologists who prescribe medications to allow the nerves to operate and function properly even if there is a problem. Pain management doctors who will do injection therapies, and if there is a problem that cannot be corrected as a result of conservative treatment the next thing people need to do is go see the orthopedic spinal surgeon and neurosurgeon.
Orthopedic spine surgeons and neurosurgeons are engaged in surgery and oftentimes will surgically remove part of the disc or the whole disc or replace the disc. We at this law office have handled thousands of these cases. We know the medicine and knowing the medicine is an extremely important part if you are going in front of a jury so you can explain these concepts to them.