Medical Case Development Series: Spinal Cord Injuries
ProjectWorks presents the second installment in our four-part Medical Case Development Series. This series is designed to guide attorneys and paralegals through the crucial elements of medical case development, focusing on medical indicators, treatment paths, and documentation essentials
This week focuses on spinal cord injury, a category with complex presentations and significant long term care considerations. Understanding both complete and incomplete injury patterns is critical in determining causation and projecting future costs accurately.
For a high-level visual overview of each topic, head over to our LinkedIn to view the accompanying graphics.
Each installment will focus on the key medical indicators to watch for, the specialists typically involved, the long-term care needs that influence cost projections, and the documentation required to establish causation. The goal is simple. Early identification leads to better medical direction for the client and stronger case valuation for the attorney.
Spinal Cord Injury Overview
Most attorneys are familiar with complete spinal cord injuries that result in paralysis or loss of sensation below the level of impact. However, several incomplete spinal cord injury conditions present differently and can be easily missed without early evaluation. If your case involves trauma, falls, gunshot wounds, compression injuries, or neurologic changes, consider whether any of the following patterns apply:
Brown Sequard Syndrome: weakness or paralysis on one side of the body with loss of sensation on the opposite. Often caused by penetrating trauma such as gunshot wounds, but may also result from inflammation or infection near the spinal cord.
Central Cord Syndrome: caused by compression or edema. Common findings include clumsiness in upper extremities, spasticity in lower extremities, and bowel or bladder issues.
Anterior Cord Syndrome: typically linked to flexion or compression injuries. Presentation may mimic a complete spinal cord injury with paralysis or sensory loss.
Posterior Cord Syndrome: rare but marked by loss of proprioception and difficulty sensing limb position or motion.
Cauda Equina Syndrome is not a spinal cord injury but involves the nerve bundle at the base of the spinal canal. Symptoms include severe low back pain, bowel or bladder dysfunction, sexual dysfunction, and lower extremity weakness. Causes may include compression, infection, spinal stenosis, epidural hematoma, or lumbar disc pathology. Early recognition is essential due to the potential for permanent deficits.
Typical Providers and Care Needs
Depending on the severity and level of the injury, evaluation and treatment may include:
Neurosurgeon
Neurologist
Orthopedist
Physical Medicine and Rehabilitation
Occupational therapy
Physical therapy
Case management
Diagnostics
Equipment
Medications
Spousal or agency home assistance
Home modification
Transportation support
Case Development Considerations
Establishing a spinal cord injury, and proving the causal relationship to the inciting event, requires a full review of medical records, a detailed client interview, and communication with treating and specialty providers for medical opinion and documentation.
Identifying these injuries early ensures appropriate medical intervention for the client and provides a foundation for accurate damages modeling, negotiation strategy, and settlement expectations.
