Neck and Back Injury
The spinal column is a stack of bones called vertebra. Between the vertebra are natural shock absorbers called intervertebral discs made up of a tough outer layer surrounding a jelly-like inner core, sometimes compared to a “jelly donut.” Running through the center of the spinal column is the spinal cord, a bundle of nerve tissues that carry communication between the brain and the rest of the body. Major nerve branches pass through openings in the spinal column to the arms, legs, and various parts of the torso. Paraspinal muscles surround the spinal column.
Age related changes to the spine are natural and universal. Discs begin to dry and weaken, and the vertebra develop arthritic changes. Almost as soon as one reaches adulthood, subtle degenerative changes may begin. Most people over 40 have some degenerative changes visible on x-rays or MRI. By age 50 or 60, an x-ray or MRI of a spine may look like “forty miles of bad road,” without causing any problems in life, at least until old age. Then a trauma causes the previously asymptomatic natural condition of the aging spine to become painfully disabling. Many of our cases involve such traumatic aggravation of the preexisting condition of the back.
In a trauma, such as a motor vehicle collision, the spine may be whipped around in a manner that causes an injury.
• The most common back injury is damage to the muscles surrounding the spine. Microscopic tears to muscle tissue lead to bleeding and formation of permanent scar tissue. While many people recover within a few weeks, the tissue may be more vulnerable to future problems.
• Trauma to the back may cause weakening of the outer layer of intervertebral discs is the area of the back placed under greatest stress. The “jelly” in the “donut” begins to bulge out, pinching a nerve and causing pain, numbness or tingling. Such a disc bulge may progress to a herniation in which virtually all the jelly is out of the donut. Depending on where it is located, it may cause motor weakness in an arm or leg, incontinence, etc. This typically requires surgery. The traditional surgery for a herniated disc involves removing the disc and fusing the adjacent vertebra with bone tissue.
• Fractures of vertebra also often require surgery to stabilize the spine with metal plates and screws, though some more subtle fractures can be managed without surgery.
• The most devastating back injuries involve damage to the spinal cord, which can produce paralysis, either paraplegia (loss of use of legs) or quadriplegia (loss of use of both arms and legs).
We have experience representing clients with all degrees of back injury. In doing so, we have worked with all medical and rehabilitation specialties, and with a variety of medical illustrators who help us explain the injury graphically to a jury.