ACC and back injuries: the relevance of pre-existing asymptomatic conditions.
The purpose of the ARCI (1992) and AI (198) Acts is to cover those who suffered from personal injury by accident. This purpose should not be distorted. This review does not aim to suggest that cover be extended to victims of disease. Equally it is inappropriate that imaging be used to detect asymptomatic, age-related change--or reveal asymptomatic abnormalities that do not place the patient at increased risk of symptoms over the general population--so as to unfairly deny coverage to the victims of accidents. This is particularly important to those who suffer personal injury to the lumbar spine where the cause is wholly or substantially an accident, and in whom, without the specified accident having occurred, personal injury (symptoms and disability) would have not been likely to occur. Physicians managing spinal disorders must correlate clinical findings with imaging studies when planning treatment. Those considering entitlement for cover under third party/ACC provisions must pay close attention to the history and clinical evaluation, correlating these with the investigation findings, and not assume that the abnormalities found on sensitive investigations are the cause of the symptoms.
Robertson
P A
PA
Orthopaedic Clinic, Mercy Specialist Centre, Auckland.
Nicholson
O R
OR
D000375:Aging / Q000502:physiology*; D019567:Back Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007346:Insurance, Accident / Q000331:legislation & jurisprudence*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009520:New Zealand; D013168:Spondylolisthesis / Q000503:physiopathology; D013169:Spondylolysis / Q000503:physiopathology; D014057:Tomography, X-Ray Computed