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  • Writer's pictureDr Josh Bonine DC

Causation Analysis of Low Speed Collision, Spine Fracture, Labral Tear and Cervical Disc Herniation

LOW speed collisions injure spines and the human body at alarming rates. Hopefully, by now it is very clear that body damage on a car is not always proportional to body damage on the patient. Labral tears, disc injuries, spinal fractures, and so many more injuries occur at such high rates. How do you find a doctor who actually manages and helps all these conditions? Well, a good start would be to find a chiropractor that acts as a quarterback on your case, and is focused on the best care for you. Proper referral for imaging to diagnose everything involved. Proper education by a provider so they understand what to look for and what to rule out. This is what sets us apart.

Demonstrating causality to a related injury is a critical part of establishing liability and can be rather complicated during a low speed automobile collision regardless of the medical evidence. In a recent published paper, the authors demonstrate a case in which the passenger had suffered multiple causally related injuries following a low speed rear end collision.

The authors state “In the present case study an unusual case of spinal fracture [acute Schmorl’s node] is described as a result of a low speed rear impact collision.” (page 25) They continue by stating “Outside of an injury litigation setting, there may have never been a need for a determination of the cause of the patient’s post-collision diagnoses and need for treatment. All of the physicians providing care for the patient gave the opinion that the cause of the spine and extremity conditions requiring surgery was the crash that preceded the symptoms.” (page 25)

The authors report “Despite the undeniable evidence of the medical imaging demonstrating acute injury from the time of the collision and the lack of any plausible alternative explanation for the symptoms and diagnoses, the insurer was nonetheless able to produce experts who disputed the cause of the patient’s injuries. An examination of the methods and opinions of the insurers expert revealed that they were lacking in a logical, factual, and scientifically valid basis.” (page 29)

In conclusion the authors report “valid basis.” The present case study serves as an illustration of the range of injuries potentially resulting from low speed traffic crashes, including spinal fracture, symptomatic disk derangement, and internal derangement of the shoulder. From a clinical judgment perspective, the fact that such injuries are relatively unusual in such collisions is largely meaningless when assessing the causation of the injuries. Temporal proximity between the collision and the onset of symptoms related to the diagnosed injury serves as the strongest index of causality for the clinician to rely on.” (page 29)


Spine & Injury Centers of San Antonio is a local network of 5 chiropractic offices. As a group, we are raising the standard of care for injured patients and their families.

If you have recently been in a car accident, or had a personal injury, sports injury, or exercise injury, and are experiencing back pain, neck pain, knee pain, whiplash, headaches, leg pain, etc, our San Antonio injury chiropractors can help!

Our goal is to get you back to living a pain-free life as quickly as possible.

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1. Freeman, Michael D. "Medicolegal causation analysis of a lumbar spine fracture following a low speed rear impact traffic crash." Saman Publishing Co. 3.2 (2015): 23-29.



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