Introduction

• Author: Samuel D. Hodge, Jr./Jack E. Hubbard
• Profession: Skilled litigator, is chair of the department of legal studies at Temple University/Professor of Neurology at the University of Minnesota
• Pages: 15-16

Introduction

Injuries involving the spine are the most common compensation claims in the United

States. Statistically, problems with the low back are the second leading cause of missed

time from work and one of the leading reasons people visit orthopedic surgeons and

neurosurgeons. Sprains and strains of the neck are the most frequently reported problem

made to insurance companies, accounting for 66 percent of all injury cases as well as 57

percent of those seeking personal injury protection benefits.1 Why then does the Ameri-

can Association for Justice tell attorneys not to use the term “whiplash” in presenting a

claim involving the neck, and why do people remain skeptical of alleged injuries to this

region of the body?

The simple answer is that multiple studies demonstrate that these injuries often resolve

themselves within three months of the incident.2 Therefore, when a person complains

of continued pain in the neck or back that interferes with activities of daily life after

months of treatment, people look suspiciously upon these assertions especially when a

claim for money is being advanced. The problem, however, is much more complicated.

No diagnostic test can verify a soft-tissue injury, nor can it show a picture of pain. While

an MRI can demonstrate a herniated disk and other structural abnormalities, it is difficult

to “age” the finding, and relating it to an incident of trauma is a matter of opinion and not

fact. For instance, studies show that a majority of asymptomatic people have significant

abnormalities on MRI testing including herniated and bulging disks. In the absence of an

MRI the day before an accident, how can one really know if the abnormality was caused

by the accident or preexisted the traumatic event? Add to this scenario the fact that 80

percent of people will suffer from back pain during their lifetime unrelated to trauma,

and it is not hard to understand why injuries to the spine are so controversial and turn

on questions of credibility.

The Spine for Lawyers is designed to help practitioners, judges, and insurance profes-

sionals understand the multifaceted medical and legal issues in a claim involving this part

of the human anatomy. Explanations are offered that will reduce complicated medical

concepts into their simplest parts. The reader not only will gain an appreciation for the

systems of the body that relate to the spine’s construction but also will learn how injuries

occur to this region. For instance, why do more than 90 percent of traumatically induced

herniated disks happen at L4-L5 and L5-S1, but they are rarely seen in the thoracic

region?

This book is divided into three segments. Part One deals with the nuts and bolts one

needs to know in understanding medicine. The text starts with an overview of anatomy

and a foundation on how the systems of the body work. The etymology of medical terms

is explained so that one can grasp the meaning of a term by simply knowing its individual

parts. Other chapters analyze in detail those systems that influence the spine such as the

skeletal, muscular, and nervous systems. Because of the explosion of diagnostic tests and