Atlanta Workers' Comp Attorney
LUMBAR INTERVERTEBRAL DISC
INJURY FROM LIFTING
An Atlanta workers' compensation attorney at McAleer Law fully understand the complexities of work-related back injuries and are here to advise you of your rights under
Georgia workers' compensation laws.
Backache and back injury are second only to headache as a cause of absence from work. Not far behind as a leading cause of work-related injury are repetitive use injuries, like
carpal tunnel syndrome. Serious back injury on the job is most common among middle-aged workers. The most prevalent site of serious intervertebral disc injury is at the L4-5 disc. A common perception of the lumbar spine is that these five relatively massive vertebrae are merely weight-bearing cylinders or blocks. This is an erroneous perception. The lumbar spine consists not only of major weight-bearing vertebral bodies but also of an intricate system of facet joints, intervertebral discs, and ligaments. The precise alignment of the lumbar vertebrae is crucial to the proper functioning of the spine, the peripheral nervous system, the lower limbs, and even the mental health and productivity of an individual.
The basic structure of the lumbar spine is best understood if it is considered in the context of its functions. The primary functions of the lumbar spine are weight bearing and flexion and extension. The function of rotation is more limited. The architecture of the lumbar spine reflects these functions. The massive lumbar vertebral bodies are held in place by fibrocartilaginous intervertebral discs, facet joints, and ligaments. The longitudinal ligaments of the lumbar spine are continuous with those of the thoracic spine and hold the vertebrae in alignment anterior to posterior. These ligaments allow considerable freedom of flexion and extension and help to contain and anchor the intervertebral discs. The facet joints of the lumbar spine are encapsulated synovial joints, which play a major role in keeping the vertebrae aligned. The way in which they interlock is unique to the lumbar spine. The orientation of the articular surfaces forms a clamp-like arrangement, which allows more flexion and extension than rotation. Inflammation of these joints may cause considerable low back pain.
Stout pedicles support the neural arch through which the elongated spinal nerve roots pass. These nerve roots are called the cauda equina. The pedicles are notched above and below to form the intervertebral foramina.
These foramina provide an opening for the roots of the spinal nerves to exit. When they become narrowed or closed by abnormal movement or slipping of the adjacent vertebrae, the nerve is compressed. Pathology at the root of a nerve is often termed radiculopathy.
The intervertebral discs are of profound importance in the lumbar region. Their basic architecture consists of three parts: a hyaline cartilage plate, which is fused to the adjacent vertebral bodies; a multilayered ring called the annulus fibrosus; and the center, or nucleus pulposus. The intervertebral discs are anchored to the bone of the vertebral bodies both at the cartilage plates and at their periphery. The concentric layers of fibrocartilage forming the annulus fibrosus retain the central nuclear material and support the vertebrae. The intervertebral disc in some respects resembles a golf ball in its construction-that is, it has a resilient core that is covered by layers of fibrous material. Aging causes the discs to change in their biochemical makeup; older discs contain less water and are therefore less resilient. The concomitant shrinkage of the discs in the elderly accounts for some loss of height. More important, the loss of resiliency increases the likelihood of herniation or rupture. The nucleus pulposus, like the surrounding annulus, is less hydrated in older persons and is therefore less able to withstand compression.
When the intervertebral disc is damaged to the point that all or part of the intervertebral disc must be removed, the procedure performed is called a discectomy. An incision is made in the lower back, and the large levator spinae muscles are retracted. This exposes the vertebral spines and laminae. To accomplish the disc removal, the lamina on the side of the herniation is partially cut away. This is called a hemilaminotomy. Then the ligamentum flavum is incised and retracted, and the dura mater surrounding the spinal cord and spinal nerves is gently wedged aside or retracted. This procedure may be performed through a very small incision with the aid of a surgical microscope (microlumbar discectomy).
Often, spinal fusion surgery is performed, sometimes in conjunction with a discectomy. Two major types of fusion are used: laminar fusion and interbody fusion. A laminar fusion involves gouging a roughened area on the dorsal surface of the laminae of the adjoining vertebrae. The facet joints are partially removed to promote fusion. Bone grafts shaped like matchsticks are then obtained from the ilium (hip bone) and laid over the roughened area. When the bone fragments grow together, the fusion is complete. With an interbody fusion, the articular surfaces of the adjacent vertebrae are cleaned off to provide a fresh surface to which a bone graft will be attached. The interbody fusion is accomplished by inserting bone grafts taken from the patient's ilium and placing them in the intervertebral joint space. This procedure can be done from an anterior approach or a posterior approach. When the bone graft and adjacent vertebrae grow together, the vertebrae form a solid cylinder. The intervertebral foramina, of course, must be properly aligned in order to avoid compression of the spinal nerves.
Atlanta Workers' Comp for Back and Lumbar Injuries
If you have been injured at work in Georgia, call the best workers' compensation attorneys who can help you with your serious Atlanta, Georgia workers' compensation back injury claims and explain what workers' compensation benefits you are entitled to. Call 404-816-7374 to learn more.
If your back injury was the result of a negligence claim, contact the Atlanta Georgia Personal Injury Attorneys at McAleer Law for help.