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Spinal Injuries

Fairfax Injury Lawyer Brien Roche Addresses Spinal Injuries

Brien Roche

A spinal injury can be life-altering. It impacts lives of victims short-term and long-term.  Spinal injuries create a host of health problems.  The spinal cord begins at the base of the skull. It extends to the lower back.  It is a composite of nerves (neurons) that transmit electrical messages to and from the brain and to and from different parts of the body. When these electrical signals are impaired they cause a loss of motor skills and sensation.

Electricity in your body is what allows you stand up straight. Also it allows you to bend over. It allows you to do things with your hands. Without it you are just a blob.

Injuries to the spinal cord are either complete or incomplete. A complete injury means that there is no sensation or controlled movement below the level of the injury. However an incomplete injury means that there is still some function below the point of the injury. Paraplegia is an injury to the spinal cord that occurs in the mid-back or lower back region. Quadriplegia is an injury that occurs in the neck area. If you have suffered such an injury contact personal injury attorney Brien Roche. Call, or contact us for a free consult.

Spinal injuries arise in a number of ways. They can be from car crashes, medical malpractice, slip and falls or acts of violence.  The compensation for such injuries varies. It will depend in part on the locale in which you live.  This article discusses these injuries and the main types of compensation open to those pursuing a spinal injury claim.

Anatomy of the Spine

The spinal column is divided into 5 different parts.  They include the cervical, thoracic, lumbar, sacral and coccyxgeal areas.  The cervical area consists of seven vertebrae.  Thoracic has 12.  The lumbar has 5.  The sacral and coccyxgeal portions are made up of individual elements early in life but they fuse into a solid bone.  This bone supports the pelvic girdle area.

Discs

The disc is made up of 2 parts.  It has a tough outer region that is called the annulus fibrosis.  Inside it is called the nucleus pulposis.  This is a Jello-like substance.  It has 2 purposes.  It allows for bending and twisting.  Also it acts as a shock absorber for the body.  The tough outer portion helps to contain the Jello-like material that is inside which has a high water content.

The neck and low back regions are very much dependent upon muscles for support.  As such good muscle tone is critical in order for a healthy neck and lower spine.

People who engage in a great deal of bending put unusual pressure on the low back.  Likewise activities such as running create a great deal of shock for the lower back.

Changes in the discs can involve a weakening of this tough outer ring.  There can also be a drying up of the liquid within the “Jello”.  As a result the disc space may actually decrease in height and become a less effective shock absorber.

In terms of the disc itself, there are a number of ways that it can fail.  It may bulge.  This means that some of the outer fibers have been torn.  This allows the “Jello” in the center to escape and put pressure on nerves.

There may also be a complete tear which is called a “herniation”.  There may also be actual extrusion where disc material escapes and begins to wander.

If there is a tear in the outer ring, typically that is not going to heal.

Movement of the Bones

Sometimes the vertebrae move due to an injury. They can move forward, backward or side to side. The movement is in relation to the vertebra below. This movement is due to an injury to the ligaments. The condition is called listhesis. This form of damage can be nicely portrayed on dynamic motion xray (DMX) that is referenced on this site.

Another tool that is available to portray these types of injuries is “Computer-Aided Radiographic Mensuration Analysis” (CRMA).  If these tests portray torn spinal ligaments, then there is justification to order further MRI imaging.  This MRI imaging ideally is performed in an upright position with 2 mm. thin-slice resolution.  This allows a radiologist to analzye the depth of the scar tissue resulting from torn spinal ligaments.

These types of tests are principally undertaken by chiropractors.  One of them is Masood Kureshi in Silver Spring, MD, phone number (301) 298-7770.

Depending on the shift of these spinal bones, there may be a basis for an impairment reading under the AMA Guidelines.

Another measurement to consider is the cervical treatment guidelines which grade strains and sprains from 1 to 5.  One is the least serious and Grade 5 is probably at a level requiring surgery.  Grade 4 is a spinal instability that can include up to 3-1/2 mm of movement.

Preexisting conditions can be a problem.  They however can be used to the plaintiff’s advantage.  The preexisting condition actually makes the injury more severe. The client is more vulnerable and therefore more likely to suffer a severe injury.

The AMA Guidelines for evaluation of permanent impairment can be used to your benefit.  This guide recognizes abnormal spinal movement as a permanent impairment.  A movement of 3.5 mm. can translate into a substantial impairment rating.

Portraying Spinal Injuries

One of the tasks in portraying back injuries is to explain it to a jury.  One way to help explain it is through Newton’s Law.  One of Newton’s laws is Force = Mass x Acceleration.  The human head weighs approximately 7% of the total body.  With any type of quick, forward or backward motion of the head there is a whiplash-type effect.  Using Newton’s law you can provide some rough calculation as to what that force is.  If you know that the weight of the head is 14 lbs. and the speed at impact is 25 mph, that basic formula gives you some idea as to the amount of force that is being applied to the head at impact. That is 14 x 25 =350.

Sometimes these types of cases involve what are called soft tissue injuries.  Soft tissue refers to the blood vessels, nerves, tendons and ligaments.  Any type of injury to those body parts can be long-lasting.  If there is a repair process that is going on then part of that repair process may result in the formation of scar tissue.  That scar tissue can result in ongoing pain and symptoms.

Types of Compensation for Spinal Injuries

Damage awards serve the purpose of placing the victim in their pre-injury condition by paying for any losses. The main types of damage are payment for medical expense and pain and suffering. In addition there are the cost of assistive devices, modifications to make the victims’ homes accessible and loss of income.

Reimbursement of Medical Expenses:   These are damages given to reimburse the victim for the treatment received and the estimated costs in the future. However these awards may be subject to a subrogation lien from the health insurer.

Pain and Suffering:  Pain and suffering damages compensate victims for the suffering from discomfort due to their spinal cord injury.

Assistive Devices:   Assistive devices such as wheelchairs, crutches and canes may be needed.

Modifications for Accessibility:  This is to pay for changes needed to make the victim’s home more accessible after the injury.

Spinal Injuries May Necessitate a Wide Range of Experts

Spinal injuries can involve a host of different medical specialists.  The neurosurgeon will decide if surgery is necessary. A neurologist is a non-surgical doctor who deals with the problems post-surgery or in lieu of surgery.

In some cases an orthopedic doctor may be involved. The spinal cord is encased within the spinal column. This is a series of interlocking bones. They are designed to protect the spinal cord from injury.  Many spinal cord injuries involve some bony injury. As a result there is the need for the orthopedic doctor.

Where a lawsuit is expected there may be a need for a host of other expert witnesses. A life care planner, in some cases a doctor, can project out what is the cost of future care. In addition an economist may be a needed to project out what the future loss of income is or present value of future care.

These witnesses depend on each other.  However the most important of these experts is the doctor. The doctor will express an opinion as to the extent of disability.   Based upon that the life care planner can then project out certain costs.  Also it is based upon that disability that the economist premises his opinions.

You must recognize this interdependence. In addition you need to recognize the priority of the doctors in laying the foundation for the other experts.

Spinal Fusions on the Rise

In the year 2011 more than 465,000 people had spinal fusion surgeries in the U.S. However some experts believe that as many as half of them were not needed. On October 28, 2013 an article from The Washington Post focused on a neurosurgeon in Florida. He was performing an excessive number of spinal fusions.

The rate of spinal fusion surgery in the U.S. has risen six-fold in the last 20 years.

The procedure is the joining of two or more vertebrae in the spinal column.  It has become more common than hip replacements.

Financial Motive

The Washington Post article found that the hospital in Florida that employed the neurosurgeon gave financial incentives for their surgeons. As a result the doctors were rewarded for performing more procedures.  The hospital was making nearly $80,000.00 per spinal fusion.   In addition the companies that sell the hardware used in the fusions were making nearly $7,000.00 per fusion.  The doctor was making $6,000.00 per procedure.

Medicare has waffled on the issue of the need for many of these fusions.

The increase in the number is in part due to the improvements in technology. There is more refined imaging. Also there are improved spinal devices. In addition there is greater demand by Americans for greater mobility.

However the money motive cannot be ignored.  The sales of spinal fusion equipment in the U.S. is nearly $5.1 billion per year. Call, or contact us for a free consult.

Alternatives To Spinal Fusion Surgery

Some experts discourage the use of spinal fusions. Problems such as stenosis, herniated discs and disc degeneration alone do not justify the procedure. There should also be problems of spinal instability or deformity.

A simpler procedure to deal with some of these problems is known as decompression.  However this procedure carries a $1,000.00 fee for the doctor. The more complex fusion has a fee six times that amount.

Spina Bifida

Although this is not a result of trauma it is a spinal cord injury. Babies with spina bifida have surgery either before or after birth. The spinal cord that protrudes through the spinal column is inserted back into the column and sealed.The condition consists of the spinal column not closing around the spinal cord.

The results of a federally funded study released on February 9, 2011 indicates that 42% of those babies who receive this surgery in the womb were able to walk compared with about 21% of those who had the surgery after birth.

There are risks with the pre-birth procedure. They include ruptured membranes resulting in C-sections. Future births may then need to be C-section.

Spina bifida is the most common birth defect in the central nervous system.  Approximately 1,500 babies are born each year with the most severe form of this condition.   Where this is not corrected children have lifelong disabilities. They include paralysis, bladder and bowel problems and excessive fluid buildup in the brain.

Chiari Malformations

Chiari malformations consist of brain tissue from the cerebellum of the brain protruding into the spinal canal.  These are congenital.   The brain tissue can block the flow of spinal fluid which surrounds the brain and spinal cord.  It disrupts signals that should be transmitted to other parts of the body.  They can result in cavities in the spinal cord that fill with fluid.

At that point, surgery is needed.  The surgery involves cutting through the skull to remove a small section of bone at the back of the skull and at the top of the vertebrae.  If the symptoms have progressed to the point where surgery is needed and is not performed, then the result can be hydrocephalus. This is a buildup of fluid inside the skull. The fluid compresses the brain causing severe neurological problems.

Seeking Legal Help For Spinal Injuries

If you have a spinal cord injury claim retain an attorney who knows personal injury law. This is the first step to obtaining what you may be entitled to because of your injury.

Call, or contact us for a free consult. Also for more info about your spinal cord injury claim and personal injury in general, see the other pages on this site. Also see the pages on Wikipedia.

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Contact Us For A Free Consultation

Spinal Injuries

Fairfax Injury Lawyer Brien Roche Addresses Spinal Injuries

Brien Roche

A spinal injury can be life-altering. It impacts lives of victims short-term and long-term.  Spinal injuries create a host of health problems.  The spinal cord begins at the base of the skull. It extends to the lower back.  It is a composite of nerves (neurons) that transmit electrical messages to and from the brain and to and from different parts of the body. When these electrical signals are impaired they cause a loss of motor skills and sensation.

Electricity in your body is what allows you stand up straight. Also it allows you to bend over. It allows you to do things with your hands. Without it you are just a blob.

Injuries to the spinal cord are either complete or incomplete. A complete injury means that there is no sensation or controlled movement below the level of the injury. However an incomplete injury means that there is still some function below the point of the injury. Paraplegia is an injury to the spinal cord that occurs in the mid-back or lower back region. Quadriplegia is an injury that occurs in the neck area. If you have suffered such an injury contact personal injury attorney Brien Roche. Call, or contact us for a free consult.

Spinal injuries arise in a number of ways. They can be from car crashes, medical malpractice, slip and falls or acts of violence.  The compensation for such injuries varies. It will depend in part on the locale in which you live.  This article discusses these injuries and the main types of compensation open to those pursuing a spinal injury claim.

Anatomy of the Spine

The spinal column is divided into 5 different parts.  They include the cervical, thoracic, lumbar, sacral and coccyxgeal areas.  The cervical area consists of seven vertebrae.  Thoracic has 12.  The lumbar has 5.  The sacral and coccyxgeal portions are made up of individual elements early in life but they fuse into a solid bone.  This bone supports the pelvic girdle area.

Discs

The disc is made up of 2 parts.  It has a tough outer region that is called the annulus fibrosis.  Inside it is called the nucleus pulposis.  This is a Jello-like substance.  It has 2 purposes.  It allows for bending and twisting.  Also it acts as a shock absorber for the body.  The tough outer portion helps to contain the Jello-like material that is inside which has a high water content.

The neck and low back regions are very much dependent upon muscles for support.  As such good muscle tone is critical in order for a healthy neck and lower spine.

People who engage in a great deal of bending put unusual pressure on the low back.  Likewise activities such as running create a great deal of shock for the lower back.

Changes in the discs can involve a weakening of this tough outer ring.  There can also be a drying up of the liquid within the “Jello”.  As a result the disc space may actually decrease in height and become a less effective shock absorber.

In terms of the disc itself, there are a number of ways that it can fail.  It may bulge.  This means that some of the outer fibers have been torn.  This allows the “Jello” in the center to escape and put pressure on nerves.

There may also be a complete tear which is called a “herniation”.  There may also be actual extrusion where disc material escapes and begins to wander.

If there is a tear in the outer ring, typically that is not going to heal.

Movement of the Bones

Sometimes the vertebrae move due to an injury. They can move forward, backward or side to side. The movement is in relation to the vertebra below. This movement is due to an injury to the ligaments. The condition is called listhesis. This form of damage can be nicely portrayed on dynamic motion xray (DMX) that is referenced on this site.

Another tool that is available to portray these types of injuries is “Computer-Aided Radiographic Mensuration Analysis” (CRMA).  If these tests portray torn spinal ligaments, then there is justification to order further MRI imaging.  This MRI imaging ideally is performed in an upright position with 2 mm. thin-slice resolution.  This allows a radiologist to analzye the depth of the scar tissue resulting from torn spinal ligaments.

These types of tests are principally undertaken by chiropractors.  One of them is Masood Kureshi in Silver Spring, MD, phone number (301) 298-7770.

Depending on the shift of these spinal bones, there may be a basis for an impairment reading under the AMA Guidelines.

Another measurement to consider is the cervical treatment guidelines which grade strains and sprains from 1 to 5.  One is the least serious and Grade 5 is probably at a level requiring surgery.  Grade 4 is a spinal instability that can include up to 3-1/2 mm of movement.

Preexisting conditions can be a problem.  They however can be used to the plaintiff’s advantage.  The preexisting condition actually makes the injury more severe. The client is more vulnerable and therefore more likely to suffer a severe injury.

The AMA Guidelines for evaluation of permanent impairment can be used to your benefit.  This guide recognizes abnormal spinal movement as a permanent impairment.  A movement of 3.5 mm. can translate into a substantial impairment rating.

Portraying Spinal Injuries

One of the tasks in portraying back injuries is to explain it to a jury.  One way to help explain it is through Newton’s Law.  One of Newton’s laws is Force = Mass x Acceleration.  The human head weighs approximately 7% of the total body.  With any type of quick, forward or backward motion of the head there is a whiplash-type effect.  Using Newton’s law you can provide some rough calculation as to what that force is.  If you know that the weight of the head is 14 lbs. and the speed at impact is 25 mph, that basic formula gives you some idea as to the amount of force that is being applied to the head at impact. That is 14 x 25 =350.

Sometimes these types of cases involve what are called soft tissue injuries.  Soft tissue refers to the blood vessels, nerves, tendons and ligaments.  Any type of injury to those body parts can be long-lasting.  If there is a repair process that is going on then part of that repair process may result in the formation of scar tissue.  That scar tissue can result in ongoing pain and symptoms.

Types of Compensation for Spinal Injuries

Damage awards serve the purpose of placing the victim in their pre-injury condition by paying for any losses. The main types of damage are payment for medical expense and pain and suffering. In addition there are the cost of assistive devices, modifications to make the victims’ homes accessible and loss of income.

Reimbursement of Medical Expenses:   These are damages given to reimburse the victim for the treatment received and the estimated costs in the future. However these awards may be subject to a subrogation lien from the health insurer.

Pain and Suffering:  Pain and suffering damages compensate victims for the suffering from discomfort due to their spinal cord injury.

Assistive Devices:   Assistive devices such as wheelchairs, crutches and canes may be needed.

Modifications for Accessibility:  This is to pay for changes needed to make the victim’s home more accessible after the injury.

Spinal Injuries May Necessitate a Wide Range of Experts

Spinal injuries can involve a host of different medical specialists.  The neurosurgeon will decide if surgery is necessary. A neurologist is a non-surgical doctor who deals with the problems post-surgery or in lieu of surgery.

In some cases an orthopedic doctor may be involved. The spinal cord is encased within the spinal column. This is a series of interlocking bones. They are designed to protect the spinal cord from injury.  Many spinal cord injuries involve some bony injury. As a result there is the need for the orthopedic doctor.

Where a lawsuit is expected there may be a need for a host of other expert witnesses. A life care planner, in some cases a doctor, can project out what is the cost of future care. In addition an economist may be a needed to project out what the future loss of income is or present value of future care.

These witnesses depend on each other.  However the most important of these experts is the doctor. The doctor will express an opinion as to the extent of disability.   Based upon that the life care planner can then project out certain costs.  Also it is based upon that disability that the economist premises his opinions.

You must recognize this interdependence. In addition you need to recognize the priority of the doctors in laying the foundation for the other experts.

Spinal Fusions on the Rise

In the year 2011 more than 465,000 people had spinal fusion surgeries in the U.S. However some experts believe that as many as half of them were not needed. On October 28, 2013 an article from The Washington Post focused on a neurosurgeon in Florida. He was performing an excessive number of spinal fusions.

The rate of spinal fusion surgery in the U.S. has risen six-fold in the last 20 years.

The procedure is the joining of two or more vertebrae in the spinal column.  It has become more common than hip replacements.

Financial Motive

The Washington Post article found that the hospital in Florida that employed the neurosurgeon gave financial incentives for their surgeons. As a result the doctors were rewarded for performing more procedures.  The hospital was making nearly $80,000.00 per spinal fusion.   In addition the companies that sell the hardware used in the fusions were making nearly $7,000.00 per fusion.  The doctor was making $6,000.00 per procedure.

Medicare has waffled on the issue of the need for many of these fusions.

The increase in the number is in part due to the improvements in technology. There is more refined imaging. Also there are improved spinal devices. In addition there is greater demand by Americans for greater mobility.

However the money motive cannot be ignored.  The sales of spinal fusion equipment in the U.S. is nearly $5.1 billion per year. Call, or contact us for a free consult.

Alternatives To Spinal Fusion Surgery

Some experts discourage the use of spinal fusions. Problems such as stenosis, herniated discs and disc degeneration alone do not justify the procedure. There should also be problems of spinal instability or deformity.

A simpler procedure to deal with some of these problems is known as decompression.  However this procedure carries a $1,000.00 fee for the doctor. The more complex fusion has a fee six times that amount.

Spina Bifida

Although this is not a result of trauma it is a spinal cord injury. Babies with spina bifida have surgery either before or after birth. The spinal cord that protrudes through the spinal column is inserted back into the column and sealed.The condition consists of the spinal column not closing around the spinal cord.

The results of a federally funded study released on February 9, 2011 indicates that 42% of those babies who receive this surgery in the womb were able to walk compared with about 21% of those who had the surgery after birth.

There are risks with the pre-birth procedure. They include ruptured membranes resulting in C-sections. Future births may then need to be C-section.

Spina bifida is the most common birth defect in the central nervous system.  Approximately 1,500 babies are born each year with the most severe form of this condition.   Where this is not corrected children have lifelong disabilities. They include paralysis, bladder and bowel problems and excessive fluid buildup in the brain.

Chiari Malformations

Chiari malformations consist of brain tissue from the cerebellum of the brain protruding into the spinal canal.  These are congenital.   The brain tissue can block the flow of spinal fluid which surrounds the brain and spinal cord.  It disrupts signals that should be transmitted to other parts of the body.  They can result in cavities in the spinal cord that fill with fluid.

At that point, surgery is needed.  The surgery involves cutting through the skull to remove a small section of bone at the back of the skull and at the top of the vertebrae.  If the symptoms have progressed to the point where surgery is needed and is not performed, then the result can be hydrocephalus. This is a buildup of fluid inside the skull. The fluid compresses the brain causing severe neurological problems.

Seeking Legal Help For Spinal Injuries

If you have a spinal cord injury claim retain an attorney who knows personal injury law. This is the first step to obtaining what you may be entitled to because of your injury.

Call, or contact us for a free consult. Also for more info about your spinal cord injury claim and personal injury in general, see the other pages on this site. Also see the pages on Wikipedia.

Contact Us For A Free Consultation

Contact Us For A Free Consultation