Common Back Injuries After a Car Accident
Due to the sudden force involved in a typical car accident, back injuries are very common in vehicle collisions. The unfortunate reality is that serious spine and associated multiple injuries in car accidents is quite high. A 2017 global study of the prevalence of back injuries shows how dangerous a car accident can be. The study considered a broad cross section of car accident victims who were admitted to the hospital within a 5 year period.
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The study found some clear and concerning results with respect to back injuries. First, it considered the location on the back for the injuries reported. The breakdown of the location of the typical back injury after a car accident is as follows:
Location of Back Injuries After a Car Accident
Understanding Spinal Regions
The human spine is divided into three distinct regions – the Cervical, Thoracic and Lumbar regions. Each region is unique in structure and serves a distinct function. Injuries after a car accident can vary greatly depending on where the injury is located. In the study mentioned above, the researchers discovered that injuries to the lumbar spine region is most prevalent after a car accident.
The Cervical Spine
The cervical spine, known more commonly as the neck, is made up of 7 stacked bones known vertebrae. These vertebrae are labeled C1 through C7. The top part of the cervical spine connects directly to the skull. The bottom part connects to the upper back around shoulder level. In general, the cervical spine naturally forms a slight curve. The cervical spine serves several important functions:
- Spinal Cord Protection. The spinal cord consists of a series of nerves extending from the brain through the spine. The spinal canal in the center of the spine creates a bony tunnel for the spinal cord to pass through. This creates a vital barrier of protection to the sensitive nerves of the spinal cord.
- Supporting head and neck movement. The vertebrae of the cervical spine have a big job to do in supporting the human head – which on average weighs 10-13 pounds. Beyond just providing the support needed for the head, the flexibility of the anatomy allows for a freedom of movement for the neck
- Blood Flow Assistance. Tiny holes in the cervical spine create passages for blood to flow through vertebral arteries from the heart to the brain. This function is vital to cognitive function, but it’s important to note that these openings are present only in the top vertebrae (C1-C6) of the cervical spine.
The Thoracic Spine
The thoracic spine is the longest of the spinal regions – containing 12 stacked vertebrae. These are labeled as T1 through T12. This spinal region runs from the base of the neck near the shoulders to the abdomen. The thoracic spine is also connected to the rib cage – which is an important anatomical characteristic of this spinal region. While the other spinal regions are built more for flexibility and mobility, the thoracic region is all about stability of your back. The thoracic spine serves several important functions:
- Spinal Cord Protection. As with the cervical spine above, the thoracic spine provides a sheath for the sensitive spinal cord – which ensures that the wiring of the human body remains undisturbed. Damage to these vertebrae can cause spinal cord injuries (discussed in more detail below).
- Rib Cage Anchor. The rib cage is vital to the architecture of the human body, and it’s structural integrity relied heavily on the thoracic spine. This allows the rib cage to provide protection for vital organs such as the heart and lungs.
The Lumbar Spine
The lumbar spine is responsible for over 60% of all injuries noted in the study above. Since the lumbar spine sits at the bottom of the spinal column, it is subject to a high stress load. Since the weight load is most significant on this region of the spine, injuries to the lumbar spine region are some of the most prevalent and painful. The lumbar spine consists of 5 vertebrae, designated as L-1 through L-5. The Lumbar spine serves several important functions:
- Support for the Upper Body. The 5 vertebrae that compose the lumbar spine are the largest comparatively. This is due to the fact that, in conjunction with a system of muscles and ligaments, these vertebrae support much of the weight of the upper body and organs – including the head and neck. The lumbar spine is also primarily responsible for weight shifting from the back to the legs – acting a weight distribution system.
- Control of Leg Movement. There are a series of spinal lumbar nerves that branch off of the spinal cord. These serve to allow the brain to control leg movement and provide the feeling of sensation to the legs. Damage to these nerves can cause radiating pain through the legs known as sciatica (discussed in more detail below).
Type of Back Injuries Common to Car Accidents
Car accidents are unique as they are primarily unexpected and sudden. They frequently involve violent impacts, and in many cases, the secondary impact is worse than the primary impact. Due to these characteristics, motor vehicle collisions are the leading cause of death in the United States. According to data collected by FARS and NASS-GES, every single day in America there are:
In a car accident situation, the human body has evolved a natural behavior that braces or tenses muscles during a collision. It’s estimated that more that 50% of vehicle occupants tense or brace prior to a collision. The body undertakes this bracing in an effort to protect structural integrity of the musculoskeletal system. However, with this tensing comes the likelihood of enhanced soft tissue or disc damage due to the rigidness involved. On the other hand, failure to brace can leave key skeletal structures highly susceptible to injury. In short, the human body is not made to withstand the sudden, violent forces in play in a car accident. Due to this, there are a number of injuries that frequently occur to the bar after a collision. These common back injuries are as follows.
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Spinal Disc Injuries
After an injury accident, one of the most common forms of injury are those related to the back back injuries most commonly related to damage caused to the discs between the vertebrae. These discs exist to spread loading evenly on the spinal column. Each disc is a flat circular capsule about an inch in diameter and one quarter inch thick. They have a tough fibrous outer membrane and the lastic core. Under stress, a discs inner material may swell pushing through its tough outer membrane. The entire disc can become distorted or all or part of the core material may protrude through the outer casing creating weak spot that presses against surrounding nerves. There are two distinct categories of disc problems. The first is referred to as spinal stenosis or a pinched nerve. When a patient has symptoms of spinal stenosis, the disc itself is not painful, but rather the material that is leaking out of the inside of the disc is pinching or irritating a nearby nerve.
This type of injury often produces pain called radicular pain, leading to pain that may radiate to other parts of the body, such as from the lower back, down to the leg, or from the neck down to the arm. Leg pain from a pinched nerve is usually described as Sciatica.
On the other hand is when a patient has symptoms of a degenerated disc – which often causes low back pain and leg pain. In these types of injuries, it’s the disc space itself that is painful. This type of pain is typically called axial pain.
Spinal Cord Injuries
In the above study, researchers found spinal cord injuries present in 6.6% of the population after a car accident. Spinal cord injuries are incredibly severe and debilitating. The spinal cord is responsible for a whole host of functions within the human body including:
- Motor Skills
- The ability to feel temperature
- The ability to sense the positioning of extremities
- The control of blood pressure, body temperature and heart rate
- The ability to control basic bodily functions – such a urination, bowel movements and breathing.
The spinal cord is essentially the wiring of the body, which allows organs to communicate with one another and the brain. This allows people to control and feel parts of their body, as well as to feel external sensations such as hot and cold. The most common cause of traumatic spinal cord injuries in the United State are motot vehicle accidents. In fact, every year in the U.S., there are over 12,000 new Spinal Cord Injury cases. Shockingly, on average, 82% of spinal cord injury patients are male, while only 18% are female. Depending on the severity, spinal cord injuries due to car accidents can cause:
- A loss of movement
- A loss of the ability to sense temperature
- A loss of sensation of vibration
- A loss of feeling of touch
- A loss of the ability to feel pain, leading to unexpected injury
Spinal Vertebrae Injuries
The bony vertebrae in the back are also highly susceptible to injury in a car accident. In general, these manifest themselves as either fractures or dislocations to the bone. However, the specific presentation of the injury can vary greatly depending on the angle, speed and other factors involved in a motor vehicle collision. The typical vertebrae injuries in a car accident are as follows:
- Compression Fracture. This type of injury often occurs after a car accident due to hyperflexion – or a front to back injury. This injury occurs when a spinal column is forced forward and downward due to the force of a motor vehicle collision.
- Burst Fracture. These type of compression fractures are some of the most serious. These occur when the bone of the vertebrae shatter due to the violent impact of a car accident. This can lead to bone fragment migrating or piercing the spinal cord.
- Subluxation. A car accident almost always causes abnormal movement in the spine – which is the primary causal factor to subluxation. In general, subluxation refers to a weakening of the vertebrae which is akin to a partial dislocation. It is often accompanied by damage to ligaments and muscles in the spine, and can lead to injury to the spinal cord.
- Dislocation. In a serious car accident, ligaments can be torn or stretched beyond their capacity. When this happens, it can lead to heightened movement in the vertebral column. When the vertebrae move out of alignment, this is known as a dislocation. Traction of surgery can be required to fuse the vertebrae back together.
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Treatment for Back Injuries after a Car Accident
Depending on the severity of the back injury, the course of treatment can vary significantly. However, unfortunately, many back injuries caused by car accidents require surgery to correct. Surgery is generally required any time the spine is so unstable that the bones are capable of moving further – which could lead to additional damage. Depending on the type of back injury, your medical provider may attempt one or more of the following procedures:
Decompression. This procedure aims to remove pressure from the spinal cord. In essence, the cause of any pressure is identified and removed. Typical causes of spinal pressure after a car accident are related to bones, discs and blood clots.
Internal Fixation. This, in essence, means surgically installing metal rods, screws and or hooks on the vertebrae to stabilize the spine and prevent ongoing or future deterioration. Typically, surgeons will use titanium rods, screws and hooks and bone crafts to complete this procedure.
Spinal Fusions. This type of procedure uses grafting to add bone from a different part of the body to the spine. Bone is typically removed from the back of the pelvis or the rib to use for this purpose. In general, the bone will fuse to the vertebrae within 3-6 months – which can stabilize the spine.
Dennis E. Sawan
Licensed in Ohio and Florida
Dennis P. Sawan
Licensed in Ohio and Georgia
Christopher A. Sawan
Licensed in Ohio and Michigan
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