Many personal injury cases involve injury to the neck and back caused by trauma, whether from a car accident, a fall, or other force that can permanently damage the spine’s supporting discs. In diagnosing disc injury, it is sometimes not clear to patients, attorneys, and insurance companies what exactly the term “herniated disc” means because the term is used as a general label without specifying the exact anatomical changes. Historically the medical profession has used the terms “herniated disc” or “bulging disc” to label a large number of very different types of spinal injuries. Some medical literature even acknowledges that lawyers have helped move the field of neuroradiology to more precisely define spinal disc injuries in order that we attorneys can better advocate for our clients in front of a jury. So it is important to understand the basic differences between types of disc injuries in order to first understand exactly what is wrong with you, what the precise treatment options are, and what your long term prognosis is because all of these factors play a role in determining an estimated value for your case.
Let us start by making a fundamental distinction between acute versus chronic disc injury. Acute disc injuries occur suddenly during an accident or some type of significant force or trauma that damages the disc. Chronic conditions tend to accumulate, develop and progress over time, also subjecting the disc to risk of injury. It is true that discs may be come herniated naturally without trauma. If the diagnostic testing shows calcification, ossification, or gas accumulation within the displaced disc material (the jelly) it tends to support an argument that the herniation was not caused by an acute trauma or force. As a personal injury attorney representing victims of accidents, the focus is on the acute traumatic injuries caused by force.
Discs in the neck and back are kind of like jelly donuts and if there is an injury or damage to the disc the jelly (nucleus pulposus) can shoot out (become extruded) and cause permanent neurological injury, including permanent paralysis, paraplegia or quadriplegia. There are many different types of disc injuries:
Concentric tears are tears of the anulus (the protective sheath of the disc).
A displaced disc is a disc in which disc material (jelly) is beyond the outer edges of the vertebral body ring.
An extruded disc is a herniated disc in which the jelly like material becomes extruded, or expelled, from the disc container. This disc material can cause a severe disruption in the nervous system and cause severe injury.
A herniated disc is sometimes referred to as herniated nucleus pulposus but the material that is being extruded can also include cartilage, bone fragments, or anular tissues. The term “ruptured disc” is another word for herniated disc but gives the impression that the cause of the rupture is a traumatic rupture of the anulus or end-plate. Sometimes the words “prolapse” or “radial tear” are used interchangably as well to describe a herniated disc. A ruptured (tearing) of the anulus is a disruption of the fibers of the anulus by sudden violent injury. The word rupture is used when a sudden violent injury to a previously normal disc occurs.
Accidents in which people suffer a severe injury, such as disc rupture, are deserving of significant financial compensation. When analyzing and handling such a case, the insurance industry may attempt to defend the case by arguing that the condition was a chronic condition that was not caused by the accident. By digging deeper into the pathology and neuroradiology of the client’s diagnosis, we can help present clearer, stronger and more precise evidence that a particular disc injury was in fact an acute traumatic injury as opposed to a chronic condition. Furthermore, the mere presence of some calcification or ossification is not always the determining factor in whether a herniated disc was caused as a result of acute trauma versus chronic conditions. The Florida Standard Jury Instructions governing legal causation allow a jury to award damages to a person who sustains such an injury even if the defendant’s negligence accompanied a preexisting condition like degenerative disc disease. Due to the fact that the natural aging process lends itself to degeneration of the spine and supporting discs, many Floridians are at risk of sustaining a traumatic disc injury or rupture caused by an automobile accident. As a personal injury lawyer here in Bonita Springs, Florida I have personally witnessed folks that get hit in a car accident and are checked out in the emergency room with X Rays and the standard exam to rule out any fractures or internal bleeding. However, accident trauma to a disc may not cause an immediate rupture and may instead trigger the onset of an injury that within days or weeks caused a disc rupture (or herniation) that causes spinal cord impingement. In these cases it is critical to call 911 and seek emergent medical condition because any such type of spinal injury puts you at risk for permanent neurological injury includes paralysis and even if treated can cause a lifetime of disability, loss of enjoyment of life, mental anguish and general pain and suffering.