Spinal Cord and Trauma

By Adler Giersch PS

For some 12,000 to 15,000 individuals a year an event occurs which completely alters their day to day lives – they sustain a Spinal Cord Injury (SCI). These injuries involve complex issues of care, recovery and long term life impacts as well as medical/legal issues the injured person and their family are neither able or equipped to handle alone.

Spinal cord injury is different from spinal trauma. A spinal cord injury involves the neural elements within the spinal canal. A spinal cord injury is most often caused by trauma to the vertebral column or the spinal cord itself. The injuries affect the spinal cord’s ability to send and receive messages from the brain to the systems which control sensory, motor, and autonomic function below the level of injury. The location and severity of the injury, (whether there is complete or incomplete nerve loss) determine which of the multitude of ways the body can and will be affected by the spinal cord injury.

Determining and documenting the biomechanics of injury early on is critical to determining how, where, and whether the means needed to pay for the short and long term care and other economic consequences of the injury may be obtained. There may be direct injury such as cuts or fragments of bone which damaged the spinal cord from a fall, being hit by a car or assault. Damage may have occurred when the spinal cord was pulled, pressed sideways, or compressed by other trauma, such as when the head, neck, or back was twisted abnormally during a motor vehicle accident.

While often times severe symptoms point to a spinal cord injury right away, there are times when the condition manifests gradually following the traumatic injury because of fluid accumulation around the spinal cord or swelling within the spinal cord itself which compress the cord. As early care is critical to achieving the best possible outcome, this latter situation is the most dangerous for the injured person and most difficult to detect for their care providers.

Statistics show spinal cord injuries are most likely to occur in men from their mid teens through their early 30s. While sporting activities cause spinal cord injuries most commonly in children and teenagers, work-related spinal cord injuries, primarily from construction work and auto accidents, are the predominate etiology of spinal cord injury in adults. Data compiled by the National Spinal Cord Injury Association break down the causes of spinal cord injuries as follows:

  • 44% – Motor vehicle accidents (automobile, motorcycle, sport utility rollovers)
  • 24% – Acts of deliberate violence
  • 22% – Falls
  • 8% – Sports, with almost 2/3 of that total from diving
  • 2% – Other causes

Involving a highly experienced personal injury recovery attorney as soon after the injury as possible can make a significant difference for the injured person. Assessing and generating evidence on critical issues can best be managed by counsel. These issues include what caused or contributed to the injury, whether it resulted from the wrongful acts of another person or entity, whether the injured person and/or their family are eligible for disability or other insurance benefits, and whether a guardian needs to be appointed to act on behalf of the spinal cord injured person to assist in coordinating care and treatment, as well as managing their day to day financial affairs.

As well as providing compassionate counsel, support and advise, the attorney has other medical/legal issues to deal with in regard to the medical necessity or appropriateness of certain medical and rehabilitative treatments, who will pay for the care, and the long term consequences and needs of the injured person and their family. To address the issues effectively, the personal injury attorney chosen must be knowledgeable about the biomechanics of neurotrauma, as well as the anatomical, physiological, psychological, and rehabilitative dynamics of the condition, and special needs which accompany spinal cord injury.

The patient with a spinal cord injury will likely require assistance with the formulation of a life care plan. Where the injury was caused by the actionable conduct of another, they will also require assistance with structuring the settlement including Medicare/Medicaid set asides and offsets. The Life Care Plan will be used by counsel in the assessment of damages the spinal cord injured person will experience, and to assist in obtaining funds and financial planning to insure the funds will be available when needed. It may also serve as a tool to demonstrate the cost effectiveness of new medical products or procedures over the long term.

Having these types of matters dealt with effectively is a necessary compliment to the efforts of the health provider team working with the injured person. Most individuals who sustain a spinal cord injury and their families are not equipped to appreciate and deal with these complex issues, especially while dealing with the shock and grief of a severe trauma, without an early referral to highly skilled legal counsel. The same can also be said about most attorneys as they are not experienced or skilled enough to navigate the host of complex insurance, biomechanical, economic, and lifecare planning issues effectively.