Articles Posted in Hernated Disc

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This is an action to recover damages for personal injuries allegedly sustained by the plaintiff when her vehicle was struck by a vehicle owned and leased by the defendant Enterprise, and operated by the defendant Driver. The accident occurred on South Edgemere at or near its intersection with South Elmwood in the Town of East Hampton, Suffolk County, New York. By her bill of particulars, a rep said that the plaintiff alleges that as a result of said accident she sustained serious injuries including central posterior protruded disc herniation at C2-3, C3-4, C4-5; left paramedian posterior protruded disc herniation at C5-6 and C6-7; acute cervical sprain and strain with radiculitis; bilateral C5-6 cervical radiculopathy; aggravation of pre-existing spine injury to the lumbar spine; disc bulge at L3-4; disc bulge at L4-5 contacting left L4 nerve roots within the neural foramen; supraspinatus tendinosis in right shoulder; brachial neuritis; and tinitus in right and left ears. In addition, the plaintiff alleges that she was confined to bed from July 4, 2009 until August 4, 2009, except to attend medical appointments, and was confined to home from July 4, 2009 until September 29, 2009 and intermittently thereafter except to attend medical appointments. The plaintiff also claims that following said accident she was incapacitated from her employment as a director of resident relations in a company, as an assisted living facility, in Massapequa, New York from July 4, 2009 until September 29, 2009, from December 5, 2009 until December 9, 2009, and from December 30, 2009 until January 6, 2010.

A source said that, the NYC defendant Enterprise now moves for dismissal of the claims against it for failure to state a cause of action as well as for summary judgment based on 49 USC § 30106 (the Graves Amendment). Defendant Enterprise submits a faxed copy of an affidavit of its employee, that lacks an original signature. The Court considers said affidavit despite its defect. The said employee indicates in his affidavit that he is a regional risk supervisor for defendant Enterprise, and that the day before the subject accident, defendant Enterprise rented its vehicle, a Chevy vehicle, to defendant Driver who signed a rental agreement. He also indicates that a search of records related to said vehicle revealed no pre-accident complaints or evidence of any performance or maintenance problems, and that defendant Driver was not employed by defendant Enterprise on the date of the accident.

On August 10, 2005, the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU), a comprehensive transportation bill that included the Graves Amendment, was signed into law. The Act is now codified at 49 USC § 30106. The section is entitled “Rented or leased motor vehicle safety and responsibility”. “The section applies to all actions commenced on or after August 10, 2005, and has been enforced as preempting the vicarious liability imposed on commercial lessors by Vehicle and Traffic Law § 388”.

A rep said that defendant Enterprise established that it is an “owner (or an affiliate of the owner) engaged in the trade or business of renting or leasing motor vehicles. In addition, the employee demonstrated through his affidavit that the plaintiff’s allegations of failing to maintain the vehicle in a proper state of repair and respondent superior are unfounded such that there is no negligence or wrongdoing on the part of defendant Enterprise. Moreover, the plaintiff’s vicarious liability claims pursuant to Vehicle and Traffic Law § 388 as against ELRAC are barred by 49 USC § 30106. The plaintiff failed to raise any opposition warranting the denial of defendant Enterprise’s request. Therefore, defendant Enterprise’s is entitled to dismissal of the complaint as against it.

A Lawyer said that, the defendant Driver seeks summary judgment in his favor dismissing the complaint as against him on the ground that the plaintiff failed to sustain a serious injury as defined in Insurance Law § 5102 (d) as a result of the subject accident.

The issue n this case is whether plaintiff failed to establish serious injury as defined in Insurance Law § 5102 (d) as a result of the subject accident.

The Court said that, on a motion for summary judgment, the defendant has the initial burden of making a prima facie showing, through the submission of evidence in admissible form, that the injured plaintiff did not sustain a “serious injury” within the meaning of Insurance Law § 5102 (d). The defendant may satisfy this burden by submitting the plaintiff’s own deposition testimony and the affirmed medical report of the defendant’s own examining physician. The failure to make such a prima facie showing requires the denial of the motion regardless of the sufficiency of the opposing papers.

Insurance Law § 5102 (d) defines “serious injury” as “a personal injury which results in death; dismemberment; significant disfigurement; a fracture; loss of a fetus; permanent loss of use of a body organ, member, function or system; permanent consequential limitation of use of a body organ or member; significant limitation of use of a body function or system; or a medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment.”
“It is well established that in threshold serious injury cases, restrictions in range of motion typically are numerically quantified, compared to the norms, and based upon identified objective tests”. “These requirements are applied to defendants seeking summary judgment, as well as to plaintiffs opposing summary judgment”. The defendants must submit admissible medical evidence demonstrating that the plaintiff’s range of motion was not significantly limited in comparison to the normal range of motion one would expect of a healthy person of the same age, weight, and height.

For a Queens plaintiff to recover under the “permanent loss of use” category, he or she must demonstrate a total loss of use of a body organ, member, function or system. To prove the extent or degree of physical limitation with respect to the “permanent consequential limitation of use of a body organ or member” or “significant limitation of use of a body function or system” categories, the plaintiff must provide either objective evidence of the limitation or loss of range of motion and its duration based on findings from an examination contemporaneous to the accident and a recent examination or the plaintiff must provide a sufficient description of the “qualitative nature” of his or her limitations, with an objective basis, correlating the plaintiff’s limitations to the normal function, purpose and use of the body part.

The defendant Driver relies on the affirmed medical reports of the defendants’ examining orthopedic surgeon, and examining neurologist. The report dated November 9, 2010 indicates that he examined the plaintiff on said date and performed range of motion testing of her cervical spine, right and left shoulders, right and left elbows, right and left wrist and hand, lumbosacral spine, and right and left ankle and foot using a goniometer. The doctor’s findings with respect to the cervical spine injury revealed decreased bilateral rotation of 30 degrees (normal 80 degrees), flexion of 10 degrees (normal 50 degrees), and extension of 10 degrees (normal 60 degrees), with no evidence of paracervical muscle spasm or atrophy. His findings regarding range of motion of the plaintiff’s lumbosacral spine injury revealed decreased flexion of 30 degrees (normal 60 degrees) limited by pain, and normal extension, bilateral lateral bending and bilateral rotation but with complaints of pain at the extremes of motion. The doctor stated that the plaintiff has evidence of symptom magnification based on her complaints of pain in her lumbar spine when he lightly touched the skin overlying her paralumbar muscles, her complaints of pain in her lumbar spine when he rotated her body at the hips while maintaining her lumbar spine completely stable, and her complaints of pain radiating from her head to her lower back when he tapped the top of her head. The doctor noted that there was no paralumbar muscle spasm or loss of normal lumbar lordosis and that straight leg raising was bilaterally full and pain free. In conclusion, the doctor opined that the plaintiff showed evidence of a resolved cervical hyperextension injury, resolved left foot contusion, resolved right shoulder strain, and resolved low back strain. He also opined that she had evidence of symptom magnification and noted that the range of motion examination is a subjective test under the voluntary control of the individual being tested. The doctor concluded that the spinal injuries appeared to be causally related to the subject accident, that the plaintiff had no pre-existing conditions affecting her recovery, and that she was presently able to perform the duties of her occupation.

The doctor indicated in his report that he examined the plaintiff on November 8, 2010 and found a normal neurological examination. However, he reported that the plaintiff’s spinal range of motion testing with a goniometer revealed lumbar flexion to 20 degrees (60 to 90 degrees normal), cervical flexion to 20 degrees (50 to 60 degrees normal), cervical extension to 20 degrees (40 to 60 degrees normal), and cervical lateral flexion to the left was 20 degrees (45 degrees normal) and cervical lateral flexion to the right was 25 degrees (45 degrees normal). The doctor also reported that the plaintiff needed effort to rotate to the left and rotated to the right 20 out of the maximum 80 degrees. He concluded his report by diagnosing cervical sprain injury superimposed upon cervical degenerative disc disease, ossified ligaments and congenitally narrowed spinal canal, and subjective headaches, “cervically mediated from spondylosis and sprain/strain.” He opined that there was no evidence of cervical radiculopathy, lumbosacral radiculopathy, or central or peripheral nervous system dysfunction and that the plaintiff’s reduced range of motion was secondary to spondylitic disease and diminished effort. He further opined that there was no causally related neurologic injury or impairment but that the cervical sprain appeared to be causally related to the subject accident, superimposed upon pre-existing degenerative changes, and that her lumbar condition appeared to be an entirely pre-existing condition.

Here, the Court held that the defendant Driver failed to meet his prima facie burden of establishing that the plaintiff did not sustain a serious injury within the meaning of Insurance Law § 5102 (d) as a result of the subject accident. The doctor reported the existence of significant limitations in the plaintiff’s cervical and lumbosacral spine range of motion more than a year after the subject. Although he stated that the plaintiff had evidence of symptom magnification and that range of motion testing is subjective, he failed to substantiate those conclusions with objective medical evidence. In addition, it appears that the doctor also found significant limitations in range of motion of the plaintiff’s cervical and lumbar spine, the extent of which is difficult to determine. He reported ranges of motion for the plaintiff’s lumbar flexion, cervical flexion, and cervical extension that were expressed in certain or definitive numerical degrees but he failed to provide the corresponding certain or definitive normal values and instead gave ranges or spectrums of degrees spanning 10 to 30 degrees for his normal standards of comparison. When a normal reading for range of motion testing is provided in terms of a spectrum or range of numbers rather than one definitive number, the actual extent of the limitation is unknown, and the Court is left to speculate. Furthermore, both physicians failed to address the plaintiff’s claim, as set forth in her bill of particulars, that she sustained a medically-determined personal injury or impairment of a nonpermanent nature which prevented her from performing substantially all of the material acts which constituted her usual and customary activities for not less than 90 of the 180 days immediately following the accident. Neither physician related his findings to this category of serious injury for the period of time immediately following the subject accident. Inasmuch as the defendant Driver failed to meet his prima facie burden, it is unnecessary to determine whether the plaintiff’s papers submitted in opposition to his motion for summary judgment were sufficient to raise a triable issue of fact.
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A forty-seven year old Staten Island warehouseman for a closet manufacturing company was operating a forklift at the workplace. This was his regular duty for the past three and a half years of employment there. Also as part of his regular job, he lifted boxes to and from the stocks. On May 16, 1996, the warehouseman was unloading a pallet of boxes. A box fell from the pile and hit him on the back of the head. He experienced pain and the weight and sudden impact of the box caused him to fall on his knee. After that incident at work, he began to experience backand neck pain.

He went to see a Westchester neurosurgeon to determine the injury he suffered and to get a diagnosis of what caused his pain. The employer and the servicing agent agreed to compensate the warehouseman and to pay him temporary disability benefits. Medical tests were conducted and the neurosurgeon discovered that the warehouseman had a preexisting medical condition called spinal stenosis. It is a kind of arthritis of the spine. It is congenital and degenerative. A traumatic injury is sometimes the first sign that a person suffers from spinal stenosis. Here, when the box fell on the warehouseman’s head, his back was twisted and the nerves in his lower spine bruised against his bone causing pain.

The neurosurgeon recommended treatment through physical therapy and restricted his lifting of heavy objects at work and in daily activities. The warehouseman’s back and neck pain was not resolved so the neurosurgeon recommended that he go on a diet to lose excess weight to relieve the weight carried by his spine but still the pain was not alleviated. In 1997, a year after the accident, the neurosurgeon recommended surgery to repair the damage to his spine.
The employer refused to pay for the surgery and stopped paying temporary disability to the warehouseman. This prompted the warehouseman to file a claim for compensation and for authorization for the surgery as well as temporary disability benefits until his maximum medical improvement.

At the trial, the neurosurgeon testified that the pain and impairment experienced by the warehouseman was attributable by seventy-five per cent to the preexisting spinal stenosis and only twenty-five per cent to the accident. The neurosurgeon concluded that the pre-existing medical condition of spinal stenosis was the major contributing cause of the warehouseman’s disability and he even opined that sooner or later, even if the warehouseman did not have the accident, he would have needed surgery on his spine.

The judge of compensation claims found that the accident in the workplace was the major contributing cause to the warehouse man’s need for a surgery on his spine. The judge took into consideration that the warehouseman has been doing manual labor for the past twenty years or so and he has not experienced back pain or disability. At his present employment, he has been working for three and a half years and he has never missed a day of work due to pain or disability until after the accident. The judge then concluded that it was the accident and not the stenosis that was the major contributing cause of the warehouseman’s pain.

The only question is whether or not the warehouseman’s disability should be compensated.
The Court found that the judge of compensation claims did not err in ruling that the warehouseman’s disability is due to the accident at the workplace and not due to the preexisting medical condition.

The Court takes note of the fact that the warehouseman was unaware of the preexisting medical condition and he has not experienced any pain because of it. The pain he suffered and which debilitated him began only after the accident at the workplace. The preexisting medical condition of spinal stenosis was aggravated or made worse by the accident. The accident was compensable.
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There are five things spine surgeons should consider when working on patients who are paying via workers’ compensation.

First: It might be best to do it in an ASC. Workers’ compensation cases often have better compensation for spine cases when they are performed in an ambulatory surgery center. A well-known spinal doctor told a rep that many of his workers’ compensation cases could easily be performed in an outpatient setting. These bolster the funding for the ASC and create a better relationship with workers’ compensation organizations.

Second: Pay attention to psychological concerns. Every doctor knows to evaluate a patient physically to get the best possible outcome for treatment. But that’s often only half the issue. Surgeons should look into the patient’s psychological health and motivation to recover, as well. Sometimes, it’s difficult for workers’ compensation patients to return work, due to psychological reasons and a lack of motivation. “We try to minimize exposure to workers’ compensation patients unless there is a motivation from the patient to get better,” a neurosurgeon said. Often, these patients have been on pain medication for a long time, which complicates matters further.

Third: Expectations influence outcomes. It had been discovered that a positive expectation for recovery is more likely to result in more complete recovery and a higher likelihood of being able to return to work.

Fourth: It may be best to keep it simple. Spinal fusion is not always the answer. One study shoed spinal fusions often led to worse outcomes for workers’ compensation patients. Most patients in the study suffered from degenerative disc disease, herniated discs, or nerve root disease. These were compared to the results of 725 patients who had nonsurgical treatment for back pain.

The study showed 11 percent of the spinal fusion patients had permanent disability. Only 2 percent of the nonsurgical patients had the same. Spinal fusion patients were also more likely to need oploid drugs for pain management. About 25 percent of the spinal fusion patients returned to work – two-thirds of the nonsurgical patients returned to work.

Fifth: Make predictions. The company employing the patient has to set aside money until the patient is healed, to pay for medical care. Many physicians don’t like to make predictions, since they fear a mistaken prediction would lead to a lawsuit. Lawyers in Queens and Staten Island know, however, that the company will simply ask the physician to revise the prediction if the numbers are off.
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While there are many people who have suffered spinal cord injuriesand have gone on to a full recovery, there are also many who must live the rest of their lives with decreased mobility due to their injuries like a herniated disc. In one doctor’s many years of experience dealing with these types of injuries, we have learned that people who have suffered from spinal cord injuries must take care to prevent pressure sores.

Although pressure sores have many names associated with them, once you have one it can take months to heal if not properly cared for. The investigator knows that pressure sores are caused by the loss of blood flow to an area of the skin that results in the skin or underlying tissue dying. This is often caused when pressure is applied to the skin area as you rest, especially if the area is somewhat bony. This is a problem with anyone who must lie or sit for extended periods, and especially when there is a loss of feeling in an area. Hospitals and doctors in Nassau and Suffolk Counties try to be sensitive to this problem and act accordingly.

It is recommended that if you have a spinal cord injury either you or your caregiver should check for a red area on your skin, as this is usually a sign that a pressure sore is beginning. If the redness dissipates after about 30 minutes after releasing the pressure it should be ok, but if the redness persists then a there is a strong likelihood that a pressure sore is forming. For those with dark skin, there will likely be a change in skin color, which may become develop into dry, flaky, and even a little lighter in color than normal.

There are so many potential problems those with spinal injuries and other disabilities must deal with daily. Although anyone can get a pressure sore, those who are immobile as in confined to either a sitting or laying position much of the time are at much greater risk. Those who have a spinal cord injury are up to 80 percent more likely to have at least one pressure sore, while about 30 percent are estimated to have more than one.
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Stem Cells, Inc. has announced the initiation of a clinical trial that will see the implantation of stem cells into patients with spinal cord injuries, a reporter learned today. The study in which the first phase will last one year, is currently open for enrollment and will include 12 patients whose spinal cord injuries like herniated discs are chronic and have occurred within varying periods of three and 12 months ago.

This is a landmark study in hospitals in Long Island and Manhattan and seeks to treat those patients who by the definition of chronic have “reached a plateau in their recovery,” and are less likely to experience increased function. This level is normally reached several months after the spinal injury occurred, sources told a relative. If successful, the long-term impacts of this study would give those patients who would have run out of available options for further treatment and rehabilitation.

It has long been recognized that spinal cells attempt to regenerate, but are unable to proceed beyond a certain point without some measure of intervention. Scientists have assisted with some regeneration by providing nutrition directly to the spinal cells. This clinical trial will attempt a new approach. Both California based Stem Cells and the doctors are hoping that the implantation of stem cells will induce the spinal cord cells to grow on their own. It is expected that if this is successful that there should be an improvement in the patient’s sensory and motor function, as well as other bodily functions such as bowel and bladder.

This is not a short-term trial. A study claims, the initial phase of the trial will last one year, during which time all 12 of the patients will have received their stem cell implantations. Once that phase is completed, an observational phase will be to monitor each patient for the next four years.

The trial will be conducted at the Balgrist University Hospital, University of Zurich, by clinical trial leader Armin Curt, MD, Professor and Chairman, Spinal Cord Injury Center at the University of Zurich, and Medical Director of the Paraplegic Center at the Balgrist University Hospital. Balgrist University Hospital is reportedly a world leader in spinal injury research, treatment, and rehabilitation.
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A high school senior, name withheld for privacy, is preparing to return to the soccer field this summer, and then play college soccer this fall, sources have told a rep. Like most high school seniors, making the transition from senior to college freshman can be a big deal. This can be an especially big deal when athletes take the step. It can be an even bigger step when the college bound athlete is recovering from a spinal cord injury.

The doctor discovered that this young athlete’s spine was fractured in three places during his last high school soccer season. His opinion is that it happened in the last game. It was not a herniated disc. Since that time, he has been out of athletics, and after surgery, he has spent much of that time in rehab and recovery. Although he has not been cleared for full contact yet, he has been cleared to resume running and weight training. He expects to be cleared for contact in about a month he said.

The senior is reportedly gaining strength and has constantly maintained a positive attitude throughout the entire affair, a friend was told. The youth’s future college coach is extremely impressed with the young man’s progress and has nothing but good things to say about him. He says that the youth has good soccer technique, decision-making skills, and a very strong work ethic. He also added that although he signed the young athlete for a certain position on the field, that he is versatile enough to play in any position the team would need him.

The highly talented and determined young man is looking forward to not only starting college next fall, but also in the upcoming summer soccer season. He insists that playing soccer is something he loves, would do every day, and has missed greatly following his injury. Doctors in hospitals in The Bronx and Brooklyn are taking note of these treatments.

He knows he has his work cut out for him and admits that everyone else has been training while he has been recovering from his injuries. He is also looking forward to the new challenges that await him, as he is able to pursue his dreams again.
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A baseball player for the Georgia Bulldogs was injured during a game when he ran into another player. Both players were trying to catch a line drive during the third inning. The player, an outfielder, was taken off the field in a stretcher and transported to a nearby hospital, reports the team trainer. The player was treated for a few minor injuries and then underwent neck surgery to stabilize his spine. At present, little information is known whether the player will suffer permanent spinal injury like a herniated disc. The player was transferred from the hospital and rehabilitation center, however.

The player is a 20-year old junior who had played 117 games for the Bulldogs. Additional stats include 91 starts and a .312 overall batting average. The player was injured in a game against Florida State. The player’s coach has offered his condolences to the player’s family and hopes the player recovers soon. The player will most likely have to miss the rest of the baseball season. Hopefully, he will be able to return next season to play as a senior.

The other player, a second baseman, was able to walk off the field without help from medical personnel. He suffered only minor injuries. This is not the first incident of a Georgia State baseball player ending up with spinal injuries. In 2009, another player was riding his scooter on campus when he was hit by a campus vehicle. The player ended up paralyzed from the waist. This ended his baseball career, says a doctor.

For now, the player will be closely monitored to determine if there is permanent injury to his spine. His coach said that the player is a strong person and that he has the ability to overcome any challenge. Recovering from any type of surgery can take time. But if the player completes physical therapy and allows his injuries to heal properly, he could be able to make a full recovery. Hospitals in Queens and Staten Island confirm this. The Bulldogs continue to play against other teams and have an overall score of 3-8. It is not known if the outfielder is currently allowed to play, indicates a manager.
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United States soldiers have a great burden to bear – literally, according to studies. One such soldier wore all the typical gear – body armor, a vest and pack for his radio, batteries, food, water, flashlight, ammunition, and all the rest of the things he needed in the field. Together with his M4 rifle, all of his equipment weight 70 to 80 pounds and he could feel the weight keenly.

He was in pain, especially when his squad was under fire. Running or diving on the ground was especially excruciating, making his neck and shoulders burn intensely in agony. Some soldiers have suffered herniated discs.

The soldier has now been back in Washington State for two-and-a-half years, doctors have learned. He has been diagnosed with bone spurs in the vertebrae of his neck. The cause? A degenerative arthritic condition. The pain can be so intense that he has trouble getting out of bed in the morning.

“This is ridiculous,” the solder told a reporter. “I’m only 25 years old. Arthritis is supposed to happen when you get old. What’s it going to be like when I’m 50 or 60?”

Unfortunately, he’s not the only one. Every U.S. Solder in Iraq and Afghanistan are similarly loaded with gear and may end up with similar spinal injuries.

Hospitals in Nassau and Suffolk have learned of a 2001 study by Army scientists which states the standard weight carried by soldiers should be no more than 50 pounds. Anything more decreases mobility while increasing the chance for fatigue and injury. The Army chief of staff hoped to reduce the weight by 2010.
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The military has been working hard to find new ways to treat musculoskeletal injuries, studies have learned. Teams of physical therapists and other specialists have been created by the Army to keep a closer eye on infantry brigades, and have implemented better screening techniques to find serious spinal injuries. Still, some soldiers say their injuries are often discounted by physician assistants, who are often the ones who see the soldiers first. These assistants determine who will get more extensive workups by doctors in military hospitals.

A sergeant in the Army with the 5th Stryker Brigade complained of a sore back during training. A physician assistant at the Madigan Army Medical Center was convinced the soreness was simply due to muscle pain.

The sergeant told an interested party that he had to pay out of his own pocket for an MRI, which showed he had a herniated disc. He went to Afghanistan in 2009 anyway, deciding to wait until returning to Washington state to be treated in summer 2010.

Medical staff are always looking for “sick-call warriors” who complain about problems that don’t exist. The sergeant feels this is the right thing to do. He told a doctor, however that “the problem is, now they treat most everyone like they are faking it.”
The Army itself says they are taking steps to change this and hospitals and doctors in New York City and Westchester County have taken note.
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While spinal cord injuries can be devastating and often life-altering, some people have managed to come back from being injured to continue on with their lives. This particular football player did and isn’t shy about telling others about his experiences. He sustained a spinal bruise last year and swore that no matter what, he would get back on the field, said the observer. He lived up to that promise to himself and is now lifting weights and running.

At the age of 33 years, many classify that as too old to be playing the brutal game of football, but that did not stop this man. Others thought it was time he packed it in. He figured otherwise and proved everyone wrong. Spinal bruising or cervical injury are serious injuries and if a player continues to play, he runs the very real risk of sustaining an even worse injury, explained the doctor. Fortunately, this footballer’s spinal cord healed well, and surgery was not necessary.

Not everyone is that fortunate. Those who have suffered a severe spinal cord injury, as the result of an accident caused by someone else’s negligence, may be eligible to file a personal injury lawsuit seeking compensation, suggested the expert in the field.

The major thing to understand about spinal cord injury is that it is often a severe enough injury that the person’s whole life gets turned upside down and they require some form of care for the duration. This is the reason for hiring a competent spinal cord injury lawyer; they know how to ensure you get the justice and compensation you need to get on with your life.

Often Manhattan and Long Island juries in cases such as this will tend to award larger amounts, because they understand that your life “will” never be the same again and it may involve a wheelchair, continual therapy, multiple operations, limited mobility and an inability to work.
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