Spinal Cord Injury
Spinal cord injury (SCI) is damage to the spinal cord because of direct trauma to the spinal cord itself or as a result of indirect damage to the bones, soft tissues, and vessels surrounding the spinal cord. According to the National Spinal Cord Injury Statistical Center, there are approximately 17,500 new traumatic spinal cord injuries each year in the United States, with 39.3% caused by vehicular accidents, followed by falls, violence, and then sports/recreational activities. Mortality risk is highest in the first year after injury compared with subsequent years.
Spinal cord damage can result in a loss of mobility and feeling. With most cases of SCI, the spinal cord is not severed, but this is not to be confused with a back injury, which might result from pinched nerves or ruptured disks. Although a person might break their vertebrae, there may not be any injury to the spinal cord. Currently the average age at the time of injury is 42 years, with men accounting for 81 percent of new SCI cases.
For those who have recently experienced an SCI, it might seem as if every aspect of their life has been affected. Victims might feel the effects of their injury mentally, emotionally, and socially. Anyone who experiences significant trauma to his or her head or neck needs immediate medical evaluation for the possibility of spinal injuries.
Victims who have experienced an SCI because of the negligent actions of another person or entity may be able to pursue a personal injury claim against the responsible party.
Signs and Symptoms of SCI
SCI may result in one or more of the following signs and symptoms:
- Loss of movement
- Loss or altered sensation, including the ability to feel heat, cold, and touch
- Loss of bowel or bladder control
- Exaggerated reflex activities or spasms
- Changes in sexual function, sexual sensitivity, and fertility
- Pain or an intense stinging sensation caused by damage to the nerve fibers in the spinal cord
- Difficulty breathing, coughing, or clearing secretions from the lungs
Emergency Signs and Symptoms
Emergency signs and symptoms of an SCI after an accident may include the following:
- Extreme back pain or pressure in the neck, head, or back
- Weakness, incoordination, or paralysis in any part of the body
- Numbness, tingling, or loss of sensation in the hands, fingers, feet, or toes
- Loss of bladder or bowel control
- Difficulty with balance and walking
- Impaired breathing after injury
- An oddly positioned or twisted neck or back
Spinal cord trauma is more than a single event. The initial blunt force damages or kills spinal nerve cells. However, in the hours and days after injury, secondary events, including loss of oxygen and the release of toxic chemicals at the site of injury, further damage the cord. It is important for victims to receive medical attention as soon as possible to avoid further damage and to begin a proper recovery plan with a trained medical professional.
Causes of SCI
An acute SCI is the result of a traumatic injury that results in some type of impact to the spine. The injury can be either a bruise/contusion, a partial tear, or a complete tear/transection in the spinal cord. SCI is a common cause of permanent disability and death in children and adults. The following are incidents that can lead to SCI:
- Birth injuries. Some injuries take place before a child is born and may occur as a result of a difficult birth or complications during childbirth. These injuries usually impact the spinal cord in the neck area.
- Falls. Falls can be misleading, as sometimes it may not appear that anything is wrong. However, experiencing a fall from a great distance or with some severe impact can cause severe damage, including injuring the spinal cord.
- Motor vehicle accidents. Being involved in a motor vehicle accident can be a traumatic experience, and all those involved are at risk of sustaining a major injury. However, the odds of enduring an SCI increase dramatically for pedestrians if they are hit by a car or a motorcycle.
- Sports injuries. Injuries can occur in all major sports, although the likelihood of an SCI occurring is more likely to take place in some of the more high-impact sports.
- Car accidents. If a driver or passenger is involved in a car accident, there is a risk of an SCI if they suffer a significant enough impact. For instance, an accident with a truck can lead to this type of injury.
- Trampoline accidents. Trampolines can cause problems as well if a person jumps too high and misses the trampoline and hits the floor. That type of impact can cause an injury.
- Violence. Gunshots or stab wounds can cause severe injury if the bullet or knife strikes the spinal cord, causing various injuries to the victim.
- Infections. In some instances, an abscess can form on the spinal cord, which can become infected and cause damage.
Surgeries to Treat SCI
SCI can result in a loss of function throughout the body. Although in many cases this can be permanent, it does not have to be as severe as once originally considered. There are several surgical procedures that a person can undergo that will help alleviate some of the pain associated with the injury as well as the ramifications of it. However, there is no complete cure. Some of the surgeries are as follows:
- Anterior cervical discectomy. This procedure removes herniated nerve tissue from the neck and can immediately relieve aches and pains. The surgeon removes the pieces from the front of the neck; there is usually a quick recovery time.
- Disk replacement surgery. In this surgery, a doctor can replace a damaged disk with a replacement made from metal or a plastic-like biopolymer material. Sometimes the replacement disk is made of a combination of the two materials. This can be a complex procedure, with the surgeon making an incision in the front of the body to assist in the removal and replacement of the disk.
- Thoracic fusion surgery. A compression injury is usually treated with rest and medication, although in some cases thoracic fusion surgery can be recommended. There are two ways for this procedure to be performed. In the first instance, doctors access the area from the front to locate the damaged area and perform a spinal fusion. They could also proceed from the back and use screws and rods to repair the spine.
- Discectomy. This is a common surgery to correct a herniated disk. The surgeon traditionally will cut an incision over the impacted area and advance toward the ruptured disk and remove it. This will remove any pressure or irritation on the spine.
- Microdiscectomy. This is the same surgery as the discectomy, only less invasive. The doctor will use a microscope to perform the surgery, and the recovery time is expected to be quicker than the more extensive version.
- Posterior surgical spinal fusion. This is similar to an anterior fusion, as a bone graft from another part of the body will be attached to the back vertebrae. As the body heals itself, the graft will become part of the vertebrae, becoming one solid bone. These types of surgeries are necessary in instances of a cervical fracture or dislocation. Posterior surgical spinal fusion is also used to fix deformities in the neck.
- Anterior cervical spinal fusion. These may take place along with a discectomy. It is similar to a posterior fusion in that a small piece of bone will be placed between two vertebrae. A cervical collar or brace might be necessary to aid the patient after the surgery.
- Lumbar fusion surgery. This long-term process is used when there is any disease or herniation. The surgeon removes the disk and replaces it with a bone graft between the vertebrae. Eventually the bone graft will fuse with the surrounding area and stop any unnecessary movement. The fusion process takes about 18 months.
- Posterior cervical discectomy. This surgery is performed to alleviate pressure in the nerve roots. Usually the focus is on the arms, legs, and neck and is performed to relieve pain.
- Epidural steroid injections. The goal of this procedure is to provide some relief of any potential back pain the patient might be experiencing. The medication in the injection coats the nerve roots and the outside lining of the facet joints of the spine; this in turn will allow the spine to heal.
Expenses Associated with SCI
As the number of people living with paralysis rise and as they age with their injury, the costs associated with treating them increase as well. Each year, paralysis costs the health care system billions of dollars. Spinal cord injuries alone cost roughly $40.5 billion annually, a 317 percent increase from costs estimated in 1998, which was $9.7 billion. People living with paralysis and SCI are also often unable to afford health insurance that adequately covers the complex secondary or chronic conditions that are commonly linked with paralysis.
Medical expenses for SCI are often well in excess of $1 million per patient. Of course, the exact costs vary depending on the severity of the injuries and the number of medical services needed. Some of the most common sources of expense include the following:
- Spinal surgery
- Trauma care, such as the use of a ventilator
- Rehabilitation, including physical and occupational therapy, speech therapy, and mental health counseling
- Long-term care, including the costs of in-home aides
- Medical equipment such as wheelchairs
- Medication such as painkillers and antibiotics
Statistics show that one year after injury, just 11.7 percent of victims of an SCI are employed. At 20 years post-injury, the figure is 35.2 percent. Consequently, the loss of earning potential is one of the most significant expenses for SCI survivors. Even if victims are able to return to work, they will still have to take time off to recover from their injuries. Unless the employer continues to pay the victim as they recover, one can expect to lose significant income.
The long-term costs of spinal cord injuries are not readily apparent, particularly when victims are focused on just surviving. Some of the additional expenses victims could incur include the following:
- Mental health issues related to the injuries. These problems can inhibit a victim’s ability to earn a living and may also necessitate additional medical expenses.
- Long-term health issues. Survivors of SCI are more likely to die young and more likely to suffer from medical issues such as respiratory infections.
- Home modifications. Many spinal cord injury survivors must install elevators or ramps to make their homes accessible.
- Additional equipment. Patients may require additional equipment, such as wheelchair-accessible vans.
Long-Term Impact of SCI
Unfortunately, there is no known cure or procedure that can fully repair or cure SCI. There is research into new treatments and procedures. However, at present there has not been any major breakthroughs.
After a person sustains a spinal cord injury, they will experience a swelling on the spinal cord, which leads to some loss of function in some aspects of the body. That swelling begins to reduce over the days and weeks following the injury, and the victim will begin to see some function return.
Healing is a slow process, as some victims report getting function back as late as 18 months after an accident. In few cases, a person will receive additional functionality back years after the incident. It is rarer still that a person will get back all their functionality. Most patients will live with some loss of function for the remainder of their lives.
How Can a Lawyer Help Victims of SCI?
For victims facing a life of living with an SCI, this time can be full of uncertainty. It is critical to keep in mind that every SCI lawsuit is different and the circumstances surrounding each case will be unique. The injury, the facts surrounding the case, how the case is handled, and a variety of other factors will differ for each victim. Some of the factors a lawyer will consider include the following:
- The victim’s pain and suffering
- The ability of the other party to cover the victim’s injuries
- Lost wages and earning potential
- Medical and other expenses
- Court costs, such as the cost of hiring an expert witness
Pursuing a Legal Case
Anyone, regardless of their age, is eligible to sue another person or entity if that other person or entity is at fault for the victim’s injury. That includes an adult or a child. A victim can still sue even if they were partially responsible for the accident that ultimately caused their injuries, since California is a comparative fault state. That means that in the state, a person is responsible for a fraction of the total damages, equivalent to the percentage that they are deemed to be at fault.
It is also important for a victim, their friends and family, and their attorney to investigate the circumstances of an injury as quickly as possible to ensure that all the details and facts about a case are gathered. The investigation should include a look at the site of the accident, inspecting any vehicles, machines, or tools involved and an in-depth conversation with all the witnesses. It is important that nothing be altered from the time of the accident. For instance, if the accident occurred as a result of a car accident, the vehicle should not be repaired or washed but remain in the same condition.
The goal of the investigation is to determine who is ultimately at fault for the accident and to prove a lack of fault on the part of the victim. The investigation will also determine if multiple people are at fault and divide the responsibility among the participants.
The Statute of Limitations in SCI Cases
As in most accident cases, a victim has approximately two years to file a lawsuit from the date of the initial accident. That time can be extended if there was some time between the accident and the manifestation of the injury.
If the case is against a government entity, the victim has six months to file the case.
If the victim is a minor, they have until their 19th birthday to file a claim, although they still only have six months if they are going to sue a government entity. In addition, the statute of limitations on medical malpractice is also shorter in these instances.
The Legal Process for an SCI Injury
After a person suffers an SCI, the future can be very uncertain both medically and financially. Although victims may have many questions, there are steps to take to help with the financial questions. Depending on the circumstances of the injury that led to the SCI, a person might have a legal right to seek damages from someone or an entity. If that is the case, they might be able to collect money from that person or entity to help defray the costs of the mounting medical bills.
To achieve that goal, there is an extensive but manageable legal process in place. If a victim has a good team of experienced lawyers behind them, the legal path before them will not be so challenging. The process involves the following steps:
- Hire an attorney. Hiring and experienced catastrophic injury lawyer is a good first step. The lawyer will talk with the victim and obtain the details of how the injury took place and discuss the ramifications for the victim.
- Research begins. Once an attorney has been hired, they will get right to work researching a case. It will include the circumstances that led to the injury and begin to explore opportunities to receive compensation for the injury, including from individuals, corporations, or insurance companies. If the injury took place at work, the lawyer would make the necessary inquiries into the location of the accident. If the injury was the result of a car accident, they will reach out to the victim’s insurance as well as others involved in the accident.
- Contacting insurance companies. The benefit of hiring an attorney for the victims is they would conduct all of that person’s correspondence with the various insurance companies, starting with an initial letter stating that they now represent the victim and that all correspondence should go through the attorney. This aspect of the lawsuit typically will take 30 to 60 days to allow for all formal correspondence between the various parties.
- Trial or settlement. After the attorney has conducted their research and established what they need for the victim’s case, the decision will rest with whether it makes sense to move forward and go to trial or try to settle the case. A seasoned attorney will apply their knowledge of the situation as well as their experience and make a recommendation on which is the best course of action to take. In the end, however, it is up to the client to make the final decision.
Resolution of a Case
There is no definitive amount that a person will receive in an SCI case. However, given the severity of the injury, these cases tend to garner higher amounts in settlement than other personal injury cases. However, victims must realize that although these cases could result in higher settlements, they take substantially more time. These types of lawsuits can take years to resolve, not months. When all parties involved are in agreement on the case, the process can move quickly. However, if there is resistance from one party, usually the insurance company negotiating in bad faith, a case can take a significant amount of time.
Los Angeles Catastrophic Injury Lawyers at ACTS Law Fight for Victims of Spinal Cord Injuries
The unfortunate fact is that the cost of SCI often extends far beyond the physical ramifications. When your job is to focus your energy on learning how to live life to the fullest again, the last thing you want to be worrying about is how to piece together the financing for the high cost of your recovery. Victims of SCI are urged to contact the Los Angeles catastrophic injury lawyers at ACTS Law today. Our attorneys can help you evaluate the liability of the parties involved, your rights to compensation, and advise what steps are necessary to obtain fair compensation for injuries and damages you have sustained. To schedule a free, confidential consultation, call us today at or contact us online.
Our offices are located in San Diego and Los Angeles, and we serve clients throughout Southern California.