A Lawyer's thoughts on Herniated Discs
In my profession, I often have clients coming to me indicating that they have herniated discs. While the diagnosis of a herniated disc which was caused by an accident is important, the term has - in my opinion - been overused and alone does not provide adequate information about injury.
What are discs and where are they located?Discs are located in between the various vertebra of the human spine. Although complex structures, the two main parts of the disc are known as the annulus and the nucleus pulposus. The annulus is the hard outer covering of the disc. The nucleus pulposus is the inner gelatinous portion of the disc. I explain to my clients that the disc acts as a sort of shock absorber to the human body.
When a physician says a disc is herniated - what does that mean?The short answer is - I am never sure. It appears that one of the problems in the medical field is the lack of an agreed upon nomenclature or description of what is going on with damaged discs. There are many times that several physicians will look at the same MRI film and describe what they see differently. Terms that are often used are herniated disc; disc bulge; disc protrusion, extruded disc etc...
What do you look for when a client has a damaged disc?The first thing that I look for is whether the damaged disc is coming into contact with anything. Common areas of contact are epidural fat, thecal sac, exiting nerve roots and/or the spinal cord. A very important factor is whether the disc is causing stenosis (narrowing). Foraminal stenosis can cause irritation of the exiting nerve root. If there is foraminal stenosis, we look to whether there is corresponding evidence of nerve root symptoms. If there is spinal stenosis, we look for evidence of myelopathy. A good physician will analyze all of these issues in order to discuss the proper treatment protocol. By doing so, those physicians can be very helpful in the attorney's analysis of his or her client's injuries.