Pre-Existing Disc Disease INCREASES Bodily Injury
Pre-Existing Disc Disease INCREASES Bodily Injury
Determining a causal relationship between a traumatic event and bodily injury can be a complex process. It is never more complicated than when there are conditions that pre-date the injury. One of the most common conditions associated with pre-existing issues is degenerative joint disease of the spine (spondylosis) or degenerative disc disease. Have you ever wondered why some older patients seem to have incredible pain levels in the presence of degenerative disc disease post trauma?
A recent article published by García-Cosamalón, del Valle, Calavia, García-Suárez, López-Muñiz, Otero and Vega (2010) reviewed the scientific literature in relation to how pain is generated in an intervertebral disc with particular attention paid to degenerative discs. They stated, “Nevertheless, in human degenerated IVDs [intervertebral discs], as well as in animal models of IVD degeneration, the number of nerve fibers in the IVD increases...” (García-Cosamalón et al., 2010, p. 1).
These concepts have implications for traumatic injury to the degenerative disc as well as trauma resulting in damage to a healthy disc. The authors affirmed, “A damaged IVD [intervertebral disc] releases nociceptive [pain generating] molecules and growth factors that promote nerve ingrowth into the disc...” (García-Cosamalón et al., 2010, p. 2). In other words, in healthy discs that are injured, the accelerated degenerative process has long term consequences, as the disc will degenerate faster and acquire additional nerve fibers.
Finally, there are some basic anatomical truths regarding the innervation to the intervertebral disc. In this paper, the authors reviewed the scientific literature and continued to state, “The IVD [intervertebral disc] is innervated by branches of the sinuvertebral nerve or by nerves derived from gray rami communicates... Furthermore, IVDs also receive innervation from two dense nerve interconnected plexuses located in the anterior and posterior common vertebral ligaments...” (García-Cosamalón et al., 2010, p. 2). Clinicians that understand the anatomy of the spine and how to properly document causality and bodily injury can assist in these complex cases involving degenerative discs and new injuries.
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Reference:
García-Cosamalón, J., del Valle, M. E., Calavia, M. G., García-Suárez, O., López-Muñiz, A., Otero, J., & Vega, J. A. (2010). Intervertebral disc, sensory nerves and neurotrophins: Who is who in discogenic pain? Journal of Anatomy, 217(1), 1-15.