What can I Expect if I have a Spinal Disc Injury?
Spinal discs, also call intervertebral discs, act like shock absorbers between each of the bones in the spine. They are made up of a harder fibrous shell, the annulus fibrosis, with a softer “jelly-like” substance inside, called the nucleus pulposus.
When a person is subjected to a rapid acceleration or deceleration in a traumatic event, such as a fall or a car accident, the spine can be hyper-flexed or hyper-extended, or both. When this happens the two vertebrae on either side of the disc pinch towards each other on one side and separate on the opposite side. When this happens, the disc can be damaged which can result in a bulging, protruding or herniated disc.
The symptoms from such an injury include pain, muscle guarding and spasms, and tingling pain or numbness extending from the spine into the arms or legs. Emergency room doctors usually order x-rays following an accident. While x-ray imaging can determine if bones were broken, they do not show the condition of the spinal discs, because the discs are made of soft tissue, not bone.
Magnetic resonance imaging (“MRI”) may be ordered to determine if you have a spinal disc injury. MRIs show the actual discs themselves and whether they are protruding into the spinal cord or pinching a nerve root exiting the spinal canal.
Doctors usually initiate care conservatively and commonly prescribe muscle relaxers and pain medication as a first line therapy. If the symptoms do not subside, physical therapy is commonly the next step.
If you do have a disc injury, your next level of care will depend on the severity of the disc deformation. Small bulges usually do not require treatment from a specialist. On the other hand, severe herniations that displace the spinal cord or a nerve root require referral to a neurosurgeon. There are many medical options between these two extremes including treatment by a pain management doctor or a neurologist.
Pain management doctors use a host of procedures in an effort to decrease pain including: facet joint injections; epidural injections of steroids and pain relievers; nerve blocks; nerve ablations; and the implantation of spinal cord stimulators.
Surgical options include a discectomy through which the injured disc is completely removed and either replaced with an artificial disc or the vertebrae above and below the disc are fused with bone or a metal plate. With a partial or “micro” discectomy only the part of the disc that is pushing on the spinal cord or nerve root is removed. Other surgical options include laminectomies, in which a portion of vertebral bone is removed to increase the size of the nerve root’s passageway to relieve the pressure caused by the herniated disc.
Intervertebral disc bulges and herniations are the most common injury we see in car and truck accident cases. Auto insurers staunchly defend these claims as people can have bulging or even herniated discs without being involved in an accident of any type. In such a situation, it is extremely important for the injured person’s attorney to prove the onset of the client’s symptoms occurred after the accident. To do this, we often obtain a client’s medical records as far back as possible to demonstrate the lack of any complaints involving neck or back pain. Disc injury cases are not easy - it pays to hire an experienced lawyer.