An Introduction to Spinal Injuries
Spine trauma is a devastating injury. There are many medical, psychological, and social consequences involved. Moreover, the cost of care and financial expenditures are often overwhelming. What may not be readily apparent is the fact that individuals with spinal injuries often have significantly shortened life spans and require considerable attendant care.
A recent American study shows that 87.8% of patients with a spinal cord injury are discharged from a hospital in under two weeks. As a result, many will spend time in a non-institutional residence or their pre-injury homes within days of suffering their injury. Estimates suggest that in serious cases such as quadriplegia, attendant care in the first year post-accident will be in excess of $800,000.00. Our lawyers understand that rehabilitation and attendant care costs accruing in the years following spinal injury can be exorbitant. We have an established track record of securing awards which reflect the costs associated with these kinds of injuries. Over the years, we have created relationships with a specialized network of health care providers who are able to work with you to achieve maximal recovery.
Causes of Spinal Injuries
Motor vehicle accidents are by far the most commonly cited source for injuries to the spine. A recent study shows that roughly 42.1% of reported injuries arise out of a car accident, followed by falls (26.7%), acts of violence (15.1%), and sporting activities (7.6%).
Upon discharge from a hospital, the most common diagnosis is incomplete quadriplegia (30.1%), followed by complete paraplegia (25.6%), complete quadriplegia (20.4%), and incomplete paraplegia (18.5%).
Unfortunately, the statistics also show that return to work following a spinal cord injury can be extremely challenging. At one year post-accident, only 11.5% of individuals have found re-employment. After 20 years, the number of re-employed individuals increases to 35.4%.
An inability to return to work undoubtedly poses many challenges for accident victims. We understand that a loss of income can be devastating and we are able to help you quantify future losses and loss of competitive advantage.
Classification and Consequences of Spinal Injuries
Cervical injuries are by far the most common type of injury to the spine. Because cervical injuries occur at the neck region, they usually result in complete or incomplete quadriplegia (paralysis to limbs and torso). Cervical spine injuries can be classified into injuries of the upper and lower cervical spine. Depending on the location and severity of injury, complications may arise with breathing, loss of function to certain muscle groups, loss of function at the wrists, hands, and fingers, and a loss of dexterity. The severity and risk of injury to an older adult as opposed to a child or young adult is greater due to osteopenia and other degenerative changes.
Cervical spine injuries can also be classified with respect to their underlying mechanism of injury. These mechanisms include:
- hyperflexion (compression of limb or part beyond its normal range)
- hyperextension (extension/overstretching limb or part beyond its normal range)
- vertical compression
- lateral flexion (flexion away from the midline of the body)
Hyperflexion injuries can result from a severe flexion force to the head and neck which causes a significant displacement of the spine, ligaments, and/or surrounding soft tissues.
Hyperextension injuries can occur when there is a force applied to the posterior of the head or upper cervical spine. These injuries usually arise out of trauma to the face or mandible, or sudden deceleration (i.e., head suddenly halted from forward motion by steering wheel or dashboard).
The Canadian Cervical Spine Group has identified several clinical criteria for predicting the extent of cervical spine injuries. The study found that certain criteria predicted a low risk of significant post-accident injury. The criteria included a fully alert patient post injury, being under 65 years of age, a fall from less than 3 metres above ground, being involved in a low speed as opposed to a high speed vehicular crash, absence of midline cervical tenderness, and the ability to rotate the neck to the left and the right.
Injuries to the thoracic regions of the spine are less common than cervical injuries. Thoracic injury usually spares the function of the hands, arms, and neck.
Finally, certain accidents may lead to the lumbarsacral injuries. The consequences of lumbarsacral injury are related to deficits in control of the hip area including the urinary and bowel systems. Individuals may also suffer from decreased ability to use their legs resulting from loss of thigh muscle contraction, quadriceps, and/or hamstrings, and extension or flexion of toes.
Management of Spinal Injuries and Complications
Many individuals with spinal cord injuries are trauma patients. As such, basic life support with full attention to airway management and breathing and circulation parameters is required. After the patient is stabilized, a determination of the approximate level and extent of injury will be made.
The initial and subsequent medical management of spinal cord injury is directed towards prevention of future complications that patients suffering from these injuries are prone to.
Such consequences may include, urinary tract infections, pressure ulcers, pain, depression, spasticity, pneumonia, autonomic dysreflexia, venous thrombosis with occasional pulmonary emboli, renal and bladder stones, renal failure, and heterotopic ossifaction. Coupled with decreased mobility, it is not surprising that spinal cord injuries significantly impact a person’s day-to-day and future quality of life. Not only is the individual who has sustained the injury affected, but for families and significant others, the effects of spinal injury are equally devastating. Often, family members will struggle to comprehend the full impact of the injury and maladaptive behavioural patterns. There is often a loss of intimacy, reorientation of roles and responsibilities, and an impact on one’s ability to cope with everyday tasks and challenges.
Our lawyers understand spinal injuries. Members of our team have experience with the kinds of challenges you and your family are undoubtedly facing, the complexity of the symptoms you may be experiencing, and the rehabilitation and accommodation that you require.