[Trauma of the spine and intervertebral disk. A challenge for the expert in compensation claims after sustained "trifle trauma"].
In the literature, the association between chronic pain syndromes of the spine and sustained "trifle trauma" is a matter of controversy. "Trifle trauma" is identified as a contusion, compression and/or sprain without a definite, acute imaging sign of injury to the bone, the disk or the ligaments of the spine. Most of the time, striking isolated changes to the intervertebral disks are interpreted as preexisting without relevance to an acute injury. However, complex chronic pain syndromes causing permanent and significant functional limitations in daily life and work may occur. Besides the diagnostic and therapeutic challenge for the treating physician, the expert confronted with compensation claims very often has to answer questions as to whether "trifle trauma" of the spine may lead to significant and permanent functional limitations or loss with chronic pain syndromes, and what the importance of possible isolated changes in intervertebral disks is. The data from literature dealing with this topic is contradictory and deficient. In this article, we critically examine the causality between "trifle trauma" to the spine and possible permanent chronic complaints based on currently available data from the literature in order to support the process of decision making in questions of litigation and controversial compensation claims.
Leidel
B A
BA
Chirurgische Klinik und Poliklinik - Innenstadt, Klinikum der Universität München, München, 80336, Nussbaumstrasse 20, Germany. bernd.a.leidel@med.uni-muenchen.de
Kessler
S
S
Mutschler
W
W
D001416:Back Pain / Q000209:etiology* / Q000523:psychology; D035881:Compensation and Redress / Q000331:legislation & jurisprudence; D003288:Contusions / Q000175:diagnosis / Q000523:psychology; D004185:Disability Evaluation; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D006801:Humans; D007403:Intervertebral Disc / Q000293:injuries*; D013124:Spinal Injuries / Q000175:diagnosis* / Q000523:psychology; D013180:Sprains and Strains / Q000175:diagnosis / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology