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Spinal Injury

Spine injuries are among the most common injuries we see in personal injury cases. This is particularly true with automobile collisions, simply because of the amount of force that is placed on the spine when there is a sudden impact between two massive objects. Even “low impact” automobile collisions can exert a dangerous amount of force on the human spine and cause permanent and debilitating injuries. This is particularly true for personal injury victims who might have an underlying physical or medical condition that makes the victim more susceptible to serious injury when exposed to these unnaturally large forces.

Facet Joint Injuries

Facet joints are located between the vertebrae in the human spine, and link the vertebrae together. The joints are covered in cartilage which helps decrease the amount of friction between them. The joints are also surrounded by a lubricating capsule, which is full of nerve fibers that can cause pain when irritated. When these joints are exposed to too much force, it can cause temporary or permanent damage to the joints. In addition to symptoms that can result from injury to the joint itself, a facet joint injury can result in the development of bone spurs that put pressure on the spinal cord.

Like most other spinal injuries, facet joint injuries can vary greatly in type and severity. The purpose of this page is to provide a basic education about common facet joint injuries and how they are handled in the setting of a personal injury case, so a personal injury victim can better understand their rights in the event of a facet joint injury.

Common Types of Facet Joint Injuries

The most common type of facet joint injury we see in personal injury cases include facet joint capsular injuries and facet joint fractures. Like other spine injuries, the severity of these facet joint injuries can vary greatly, and, accordingly, so do the treatment options.

Facet Joint Capsular Injury

Facet joint capsular injuries are probably the most common type of facet joint injury. While some facet joint capsular injuries are referred to as whiplash, it seems that term has been used flippantly to trivialize the true severity of the injury. Facet joint injuries can include a sprain, rupture, or other trauma to the capsule surrounding the facet joint, which, as previously noted, has nerves. When the capsule is damaged, it can cause significant pain and discomfort. Facet joint injuries are particularly common in car crashes, due to the amount of force the facet joint is exposed to during the event.

Facet Joint Fractures

When exposed to enough force, the facet joint, which is bony, can fracture. Facet joint fractures, like other fractures of bone, can range from minor to severe. While facet joint fractures (or dislocations) are rare, this can happen when the joint is exposed to sufficient force.

How Facet Joint Injuries Are Diagnosed

While most facet joint fractures can be diagnosed using common imaging tools such as x-rays or MRIs, most facet joint capsular injuries cannot. In some instances, a facet joint capsular injury can be diagnosed based on a physical examination by a medical doctor. However, the most effective tool for diagnosing a facet joint capsular injury is the use of a diagnostic injection called a facet joint block. By deadening the sensory nerve(s) near the suspected injury site, the injury victim often gets substantial relief from the pain. While relief of the pain from a nerve block injection is only temporary, it can help the injury victim engage in conservative care, such as physical therapy or chiropractic care, with substantially less pain.

How Facet Joint Injuries Are Treated

Because facet joint injuries can range from minor to severe, the treatment protocol varies from person to person. For minor injuries, conservative treatment such as physical therapy can be extremely effective. When conservative treatment fails, facet joint nerve blocks, which are primarily diagnostic, can be used to obtain temporary relief of pain. If the facet joint block is effective, the injury victim might be a candidate for a Radiofrequency Neurotomy (RFN), where the nerve that is sending the pain signal from the site of the injury is ablated (burned), providing a longer-term solution for pain relief. Because the nerve will regenerate, RFNs must often be performed periodically to manage the pain.

Similarly, treatment of a facet joint fracture can vary depending on severity of the injury. For minor facet joint injuries, immobilization and conservative care might be sufficient. For major face joint injuries or dislocations, surgical intervention might be required in order to stabilize the joint.

Are Facet Joint Injuries Serious?

They can be. Like other spinal injuries, facet joint injuries impact everyone differently. Some people who suffer minor facet joint injuries can make a full recovery without the need for any type of invasive medical procedure, such as injections or surgery. However, moderate and severe facet joint injuries can result in the need for long-term pain management or surgical intervention. Like any other spinal injury, an injury victim should be very proactive in treating their facet joint injury so they can have a better understanding of whether the injury will resolve or require long-term care.

Should I Talk To A Personal Injury Lawyer If I Have Been Diagnosed With A Disc Injury?

Yes. Like with spinal disc injuries, insurance companies and defendants will try to take advantage of an injury victim who has not done a thorough job of understanding the nature and extent of their injury. Additionally, insurance companies and defendants will deny the severity of a facet joint injury that is not revealed by traditional diagnostic imaging tools.

Many personal injury victims choose to simply wait and see if their symptoms subside. Unfortunately, waiting can create gaps in the victim’s medical care that can make it more difficult to prove that a facet joint injury (or other injury to the spine) was actually caused by a specific event. This dramatically increases the chances the injury victim will have to engage in a lawsuit in order to prove their case and obtain adequate compensation for their loss.

By talking to a personal injury lawyer, an injury victim can receive personalized guidance relating to their unique circumstances, and learn their options for obtaining an understanding of and treatment for their facet joint injury, so the victim is able to prove the extent of their loss to an insurance company or jury. Additionally, a personal injury lawyer can help the injury victim identify the long term consequences and costs associated with a facet joint injury so the victim can be compensated accordingly. It is true that failing to talk to a personal injury lawyer about a facet joint injury can cost the injury victim many thousands of dollars.

Intervertebral Disc Injury Claims

The human spine has 24 pieces of cartilage, called intervertebral discs, between each of the vertebrae. The intervertebral discs provide several functions, including helping to absorb shock to the spine, and protecting the spinal cord. Each disc has a strong outer layer called the annulus fibrosis, filled with a gooey substance called the nucleus pulposus.

Intervertebral disc injuries can vary greatly in type and severity. Even similar disc injuries can result in dramatically different symptoms, treatments, and recoveries from person to person. The purpose of this page is to provide a basic education about common intervertebral disc injuries and how they are handled in the setting of a personal injury case, so a personal injury victim can better understand their rights in the event of a disc injury.

Types of Intervertebral Disc Injuries

There are three common types of disc injuries that can be caused or aggravated due to trauma: disc herniations, disc bulges or protrusions, and annular tears. Knowing the basics of each of these types of disc injuries can help a personal injury victim make smart decisions and avoid damaging or jeopardizing their personal injury case.

  1. Disc Herniation – When the nucleus pulposus is forced out of the annulus fibrosis, the disc has herniated, or slipped. Depending on the severity of the herniation, a herniated disc can cause inflammation in the spine and, in some instances, compress the nerves that run through the spinal canal. When this happens, the injury victim can often feel like they’ve pinched a nerve, and it can be extremely painful. A herniated disc can also cause the victim to feel strange sensations, such as numbness, tingling, burning, or pain, away from the spine and in their extremities, like their arms, legs, hands and feet. A herniation can be caused by a specific traumatic event, such as a fall or collision.
  2. Disc Bulge – A disc bulge, also called a disc protrusion, occurs when the annulus, or outer layer of the intervertebral disc, protrudes further than it should, but where the nucleus pulposus (the jelly inside the disc) remains inside. When the disc bulges so far that it puts pressure on the spinal cord, it can cause significant pain and discomfort similar to the symptoms present in a herniated disc, including symptoms that radiate into their extremities. While bulging discs typically occur as a result of aging, it is common for a bulging disc, which is not causing any symptoms, to be aggravated or disturbed and become symptomatic. Like a disc herniation, this could occur in a specific traumatic event.
  3. Annular Tear – An annular tear occurs when the annulus has torn, but where the nucleus pulposus is not extruding through the annulus. Annular tears can vary in severity, depending on how many layers of the annulus are torn and the nature of the tear itself. There are three types of annular tears, including radial tears (full tear of the annulus from inside to outside), peripheral tears (outer edge of the annulus), and concentric tears (between the layers of the annulus). Like a disc herniation or disc bulge, an annular tear can be caused or worsened by a traumatic event, like a car crash or fall.
How Disc Injuries Are Diagnosed

The best way to identify the existence and severity of a disc injury is through diagnostic imaging such as an MRI or, in some instances, a myelogram. In addition, electromyograms (EMGs) can be used to see whether a nerve signal is being disrupted by the disc injury, which can help locate a disc injury that is interfering with a nerve and causing pain or discomfort. While a medical doctor can perform a neurological exam to determine whether there is cause for concern about a disc injury, diagnostic imaging will tell the medical provider much more about what is actually going on inside the victim’s spine.

It is very uncommon, except in extreme circumstances, for either of these tests to be performed in an emergency room after a person is injured, even when the victim has symptoms that might indicate a disc injury. Rather, emergency rooms typically perform x-rays, which do an inadequate job of helping to visualize any disc injuries. Many emergency room doctors and even specialists will encourage the injury victim to wait some period of time before undergoing an MRI or other diagnostic imaging because they are costly and involve radiation. However, the value of these diagnostic tests in helping the injury victim understand the extent of the disc injury cannot be overstated. In some instances, obtaining the imaging soon after the injury event will reveal inflammation near the site of the injured disc, which can be critical in proving the disc was actually injured in a specific, identifiable event

How Disc Injuries Are Treated

Treatment of an injured disc varies from person to person and case to case. In most cases, medical professionals will recommend conservative care, such as physical therapy, chiropractic care, and traction, as well as prescription medication, such as pain relievers and oral steroids. If that is unsuccessful, it is common for the victim to seek treatment from a pain management physician, who can perform a serious of injections, called Epidural Steroid Injections (ESIs), to see if the injection will reduce inflammation and provide relief to the nerves in the spine. While ESIs can provide relief, it is often temporary. If the injury victim does not get relief from conservative measures or pain management, the victim might require surgical intervention, such as a decompression surgery to relieve pressure on the nerve, and/or a fusion to prevent pain caused by movement of the spine.

Are Disc Injuries Serious?

Disc injuries can range tremendously in severity. In some instances, an injured disc will cause no symptoms at all. In other instances, the injury could lead to paralysis and loss of bladder and/or bowel control and require immediate emergency surgical intervention. Additionally, people can have dramatically different symptoms and recoveries even when their disc injuries are very similar. For example, even if an injury victim has spine surgery to alleviate the symptoms of a disc injury, the surgery can cause adjacent joints to wear out faster than they otherwise would. This is called adjacent segment disease, and can also be very serious and warrant more surgical intervention. If a personal injury victim has symptoms consistent with a disc injury, it is extremely important they be proactive and diligent in confirming the diagnosis and receiving medical care. A personal injury victim cannot properly or adequately negotiate with an insurance company or present their case to a jury unless they have a thorough understanding of the severity and future implications of their disc injury.

Should I Talk To A Personal Injury Lawyer If I Have Been Diagnosed With A Disc Injury?

Yes, you should. It is common for defendants and insurance companies to deny that a disc injury was caused by a specific injury event. This is primarily because most people, with time, have degenerative changes that occur with their intervertebral discs, and defendants attempt to confuse jurors about whether a disc injury was traumatic or caused by the wear and tear of life. However, if the injury victim was not symptomatic prior to the injury event, and only became symptomatic after the event (or prior symptoms dramatically worsened), it can frequently be proven that the injury was related to a specific event.

It is important to at least talk to a personal injury lawyer if an injury victim has been diagnosed with or is concerned they have sustained a herniated disc, bulging disc, or annular year. Because the injury victim can seek compensation for their economic and non-economic losses, it is important that the victim truly understand the consequences of their disc injury, or at least get guidance on the importance of obtaining a proper diagnosis. In addition to helping the victim identify their recoverable economic damages up to the time of settlement or trial, a personal injury lawyer can help the victim learn the economic and non-economic impact the disc injury will likely have on the victim for the remainder of the victim’s life. A victim who fails to take the time or exhaust the resources necessary to prove the long-term consequences of the disc injury will almost certainly fail to obtain adequate compensation for their loss. However, a personal injury lawyer will help the victim learn more about the real extent of their disc injury, and work with experts to understand and prove the losses the victim will likely sustain in the future because of the disc injury. In doing so, a personal injury lawyer can help increase the victim’s compensation by thousands, tens of thousands, hundreds of thousands, or even millions of dollars in some circumstances.

Spinal Cord Injuries

The spinal cord is a group of nerves and cells that is located inside the spinal column. It is a major component of the human central nervous system, and, along with the nerve roots that branch out from it, transmits nerve signals throughout the body. The spinal cord is protected by the vertebrae, as well as the intervertebral discs in the spine. Spinal cord injuries can be catastrophic, life-changing events. The purpose of this page is to provide a basic education about spinal cord injuries and how they are handled in the setting of a personal injury case, so a personal injury victim can better understand their rights in the event of a spinal cord injury.

Types of Spinal Cord Injuries

There are two main categories of spinal cord injuries: incomplete spinal cord injuries and complete spinal cord injuries. An incomplete, or partial, spinal cord injury occurs when the spinal cord is only partially compressed or severed. A complete spinal cord injury occurs when the spinal cord is completely compressed or severed. Spinal cord injuries can result in a permanent decrease of sensory and motor function, and, in some cases, paralysis. The most common types of incomplete spinal cord injuries are Anterior Cord Syndrome, Central Cord Syndrome, Posterior Cord Syndrome, Brown-Sequard Syndrome, and Cauda Equina Lesion.

Incomplete Spinal Cord Injuries

The spinal cord can become partially severed as a result of trauma. An incomplete spinal cord injury can occur at any level of the spine. In the event of an incomplete spinal cord injury, the victim will retain some motor and sensory function below the level of the injury. In other words, the injury victim will not suffer from complete paralysis. The most common types of incomplete spinal cord injuries are Anterior Cord Syndrome, Central Cord Syndrome, Posterior Cord Syndrome, Brown-Sequard Syndrome, and Cauda Equina Lesion.

Anterior Cord Syndrome

Anterior Cord Syndrome occurs when there has been damage to the anterior portion of the spinal cord. Because a portion of the spinal cord remains intact after this kind of trauma, the spinal cord injury victim will retain some sensory and motor control below the level of the injury. Spinal cord injury victims suffering from Anterior Cord Syndrome might experience weakness, loss of pain sensation, and loss of temperature sensation below the level of the injury. In some cases, Anterior Cord Syndrome can result in loss of motor function, but retention of some sensory control below the level of the injury. Unfortunately, treatment options for Anterior Cord Syndrome are limited, and the prognosis is usually poor.

Central Cord Syndrome

Central Cord Syndrome results from traumatic injury to the cervical spine (neck). Spinal cord injury victims who suffer from Central Cord Syndrome typically experience weakness in their arms and hands, and some sensory loss or weakness in their legs and feet. In some instances, the spinal cord injury victim might also suffer loss of bladder control because of the injury. Central Cord Syndrome most often results from trauma, including damage to one or more intervertebral discs. The prognosis for spinal cord injury victims who suffer from Central Cord Syndrome can be very good. In some incidents, the spinal cord injury victim can make a full, or near-full recovery from the injury. Sometimes, surgical intervention is necessary to alleviate compression on the spinal cord to prevent or lessen any permanent symptoms from resulting from the spinal cord injury.

Posterior Cord Syndrome

Posterior Cord Syndrome results from injury to the posterior portion of the spinal cord at any level of the spine. Spinal cord injury victims who suffer from Posterior Cord Syndrome typically experience a change or deterioration of the victim’s sense of body position, motion, and equilibrium, such as spatial orientation, in the levels below the injury. However, a spinal cord injury victim experiencing Posterior Cord Syndrome will typically maintain some or all of their actual motor control. Like other spinal cord injuries, the prognosis for spinal cord injury victims suffering from Posterior Cord Syndrome varies from case to case.

Brown-Sequard Syndrome

Brown-Sequard Syndrome results from injury to one half of the spinal cord at any level of the spine. Spinal cord injury victims who suffer from Brown-Sequard Syndrome typically experience paralysis and deterioration of the victim’s sense of body position, motion and equilibrium on one side of the body, as well as loss of temperature and pain sensation on the other side of the body. Treatment of Brown-Sequard syndrome depends on what caused the injury in the first place. While prognosis is typically poor, it depends on the nature of the injury as well as the individual spinal cord injury victim.

Cauda Equina Syndrome

The Cauda Equina is a bundle of nerves located in the lower back, below the level where the spinal cord ends. When this bundle of nerves is damaged, it can have serious consequences, including numbness and tingling in the groin area, severe back pain, sexual dysfunction, and even loss of bladder and bowel control. Cauda Equina Syndrome can result from trauma or compression to the Cauda Equina. In some instances, damage to an intervertebral disc, such as an intervertebral disc herniation, can compress the nerves in this region and result in Cauda Equina Syndrome. As a result, spinal cord injury victims who are suffering from Cauda Equina Syndrome require emergency surgical intervention to decompress the spinal cord. If decompression is successful, conservative care, such as physical therapy, can help a spinal cord injury victim recover from an injury that results in Cauda Equina Syndrome. However, if the damage is severe enough, symptoms can be long-term or permanent.

Complete Spinal Cord Injuries

Complete spinal cord injuries, on the other hand, commonly result in tetraplegia (quadriplegia), which is paralysis below the site of the injury, or paraplegia, which is paralysis in the lower half of the body. As advances in medicine continue at an exponential rate, spinal cord injury victims who have sustained a complete spinal cord injury are closer to new and improved treatments every year, including advanced prosthetic devices and medication geared towards regenerating damaged nerve cells. However, though complete spinal cord injury treatments options are advancing, spinal cord injury victims typically require extensive ongoing care in order to prevent or treat secondary problems that can arise because of the devastating nature of these injuries. In addition, complete spinal cord injury victims require extensive rehabilitation in order to maintain and strengthen their muscle function in order to help the spinal cord injury victim begin to adapt to a new way of life.

Should I talk to a personal injury lawyer if I have been diagnosed with a spinal injury ?

We think you should. Spinal cord injuries, whether incomplete or complete, can dramatically change the spinal cord injury victim’s life, as well as the lives of the victim’s loved ones. Aside from causing significant changes in the spinal cord victim’s physical capabilities and, in some cases, independence, spinal cord injuries can require extensive and expensive medical care. In fact, some spinal cord injury victims can require a lifetime of ongoing medical care.