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Assessing Neurological Symptoms in Spine Injuries
Author: | Wednesday August 25, 2010
Thomas Morrison, M.D. at right with other members of the medical team. Undiagnosed conditions can lead to lasting negative consequences for patients.
Spine Injuries:
Importance of Assessing
Neurological Symptoms
By Dr. Thomas J. Morrison, III, M.D., Peachtree Neurosurgery, P.C.
One of the biggest challenges facing the workers’ compensation community is the effective treatment and management of spine injuries and the pain that can be associated with them.
However, it is not commonly appreciated how critical comprehensive assessment of these injuries is in order to prevent a temporary injury from becoming a permanent problem.
If there is a neurological component to the injury the complainant has sustained, his or her ultimate return to work at a level of fullest functionality hinges on timely and appropriate care. Unfortunately, once injured, nerves do not regenerate in the same fashion as muscles. Patients often cannot regain neurological function if too much time has elapsed between the injury and the definitive treatment. Time becomes the complainant’s (and the employer’s) worst enemy.
One of the first indications of nerve involvement in the injury can be radiating pain, numbness, tingling, burning, or even muscle weakness. As the nerve is impinged upon, inflamed, or further injured, the pain can carry down from the nerve root out along the dermatome (sensory distribution) of the nerve. This is often referred to as “radicular pain” or “radiculopathy.
” If the injury is cervical in nature, that pain may be felt down into the arms, fingers or shoulders. If thoracic, it can move around the trunk of the patient.
If the injury is to the lumbar spine, the patient may experience excruciating pain into the buttocks, thighs, or even as far as the toes, sometimes causing great difficulty in walking. In some cases, patients may have muscle weakness in the area affected or even muscle atrophy.
Of particular concern is any sort of “saddle anesthesia,” or numbness in the genital region, which can be a precursor to cauda equina syndrome. This is a very serious condition that can result in bowel or bladder incontinence, sexual dysfunction, and sometimes paraplegia.
These sorts of nerve injuries can stem from herniated discs, spondylolisthesis (“slipped discs”), and osteophytes (“bone spurs”).
Moreover, when undiagnosed, these conditions can worsen and have increasingly severe symptoms.
If left untreated for too long, the lasting consequences patients may have, including paralysis of the affected limb, loss of motor function and sensation, and intractable pain, may compromise their ability to return to their position without major accommodations. While an injury can cause many of these problems, it can also exacerbate an underlying condition that may have previously not been symptomatic.
There are many treatment options for patients with spine injuries. Physical therapy and traction can be of benefit, as can oral steroids. In addition, many patients experience complete relief from their symptoms after receiving epidural steroid injections.
Time becomes the complainant’s
(and the employer’s) worst enemy.
Some patients do require surgery to address their spine problem. Nevertheless, the critical issue is to determine if there is any neurological component of the injury as early as is possible, so that it can be vigilantly watched and considered at every stage of the patient’s care to help prevent permanent neurological injury.
Ed. Note: Dr. Thomas J. Morrison, III, M.D. is a board-certified neurosurgeon who is fellowship-trained to treat complex disorders of the spine and spinal deformities. He is a partner with Peachtree Neurosurgery, P.C. and practices at Northside Hospital Atlanta, Northside Hospital Forsyth, and St. Joseph’s Hospital.
For more information, visit www.peachtreeneurosurgery.com
or call our New Patient Coordinator at 404-256-2633.
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