Herniated Disc C4/C5 and C5/C6 Injuries
Brian White | December 24, 2020 | Car Accidents
Herniated cervical disc injuries are common in car accidents. It is important to understand that herniated discs are different from soft tissue injuries – though they may come with soft tissue injuries as well. They are more serious, more complex, and often, more difficult to treat.
Discs: Location and Function
Our spines are composed of bones called vertebrae. Vertebrae run from the neck to the lower back. Discs separate and cushion the vertebrae.
Each disc has two parts. The outside is made up of tough fibrous bands called the annulus. The other part is the jelly-like interior of the disc. It is this part that actually acts as a cushion between the vertebrae. When a disc becomes herniated, the annulus tears, and the jelly-like substance leaks through the outer protective bands. This causes pain.
Herniated Discs: Common Consequence of a Car Accident
When a collision occurs, the car that is hit absorbs the energy or momentum of the other car. What energy is not absorbed by the vehicle must be absorbed by the people inside the car.
When a car traveling 30 mph rear-ends a stopped car, for example, the point of impact absorbs the energy of the forward motion as it crumples. Usually, the driver and passengers in the stationary car are seat belted. The seatbelt prevents most of the torso from violent movement resulting from impact.
A person’s body, whether seat-belted or not will continue to absorb energy until the forward motion stops. Even the internal organs can move during an accident. It is this movement that often causes death. The head which is unrestrained, will often move violently forward and back or side to side depending on the angle of the impact.
In a car accident, the most common vertebrae injured are the C4-C5 and C5-C6 pairs. These are found in the cervical spine, which is in the neck. When these vertebrae are injured, the primary discomfort may be in another part of the body. That is because the herniated disc may be causing nerve root impingement.
Diagnosis: C4-C5 and C5-C6 Herniated Disc Injuries
These injuries are not detectable by an X-ray. After an accident, a person may go to the emergency room for treatment where X-rays may be taken to rule out any fractures. X-rays are good at showing us the interior bony structures. They cannot show the softer tissues inside such as organs, muscles, or discs.
A full examination and possible imaging may be needed to fully understand the type of injury and its severity. Some of the first clues a doctor has are where a person feels pain or weakness. C4-C5 herniations may cause weakness in the shoulder or deltoid region. C5-C6 herniations may cause weakness in the arm, perhaps down to the thumb area.
An imaging scan such as an MRI can confirm the location of the herniated disc and determine what nerves are involved. MRI scans use radio waves and a magnetic field to create images of the body’s internal structures.
A myelogram is another imaging technique. The dye is injected into the spinal fluid and then x-rays can reveal where there is pressure on the spinal cord or nerves as a result of the herniation.
Cervical Herniation Symptoms
With herniation, the patient may feel neck pain. This pain, numbness, weakness, or tingling can radiate through the shoulders with a C4-C5 injury. With a C5-C6 injury, the pain, numbness, weakness, or tingling can radiate into the arm and down into the thumb side of the hand. The pain can feel like an electric shock.
Treatment of Herniated C4-C5 and C5-C6 Discs
Treatment usually begins with nonsurgical interventions. Pain medications and anti-inflammatory medications may be prescribed. Immobilization with a neck brace can promote healing of the vertebrae and soft tissues around them. Therapeutic exercise may improve neck function, decrease pain, and increase the range of motion.
The next level of treatment may include steroidal injections into the spinal epidural space, neuroforamen, or in the facet joints of the neck. All these points are critical to the ability to move easily and without pain.
Finally, the next level of care is surgical intervention.
Surgical intervention may be needed if symptoms persist, and especially in the case of:
- Pain that is poorly controlled or intense
- Numbness or weakness
- Difficulty standing or walking; or
- Loss of bladder or bowel control.
Any of these signs can point to a herniated disc that is not healing. There are a number of surgical interventions possible. The goal of the surgery is to remove the part of the disc that is herniated and to relieve any nerve root or spinal cord compression. Surgery can ease pain, weakness, numbness, and tingling.
The most type of surgery for a C4-C5 injury is an anterior cervical discectomy and spine fusion (ACDF). In this surgery, the disc is removed, and space is created for the adjacent vertebrae to eventually fuse together and heal. The disc may instead be removed, and an artificial disc inserted in its place. This surgery can be done either from the front or rear of the neck.
C5-C6 disc surgeries include the above and other options as well. The type of surgery chosen will depend on the specifics and severity of the injury. It can take months to recover from spinal surgery.
The Personal Injury Claim and Lawsuit
The level of care needed affects the medical costs incurred and has a direct correlation to the amount of any recovery in a personal injury claim. These recoveries vary widely depending on the nature of the injury, the treatment needed, and the limitations post-surgery. For example, younger accident victims who have physical jobs may have more damages in lost wages than an older person with a desk job.
Texas has an “eggshell plaintiff” approach to pre-existing vulnerabilities, such as age in this instance. Under the “eggshell plaintiff” rule, the plaintiff’s pre-existing weaknesses or vulnerabilities cannot be used as a defense in a personal injury claim. This is important in these cases because as we age, our spinal health can deteriorate.
These can be complicated issues to sort out and if you have an injury along this line, you will need an experienced personal injury attorney to help sort them through. Never depend on an insurance company to take care of your needs.