Overview

Spinal injuries are the bread and butter of personal injury practice. They span the full spectrum from minor strains that resolve in weeks to catastrophic spinal cord injuries that cause permanent paralysis. The vast middle ground of herniated discs, spinal stenosis, and radiculopathy constitutes a significant portion of injury caseloads.

This guide provides a comprehensive litigation guide to spinal injury cases in California, with particular attention to the causation battles that define these cases and the pre-existing degeneration defense that appears in virtually every case.

Key takeaway
Degenerative changes are not a defense to causation. They are a vulnerability that makes the client more susceptible to injury. The key is establishing the client was asymptomatic before the accident and became symptomatic after. The substantial factor test under CACI 430 is your best friend in spine litigation.

Spinal Anatomy

The spine has five regions: cervical (7 vertebrae), thoracic (12), lumbar (5), sacral (5 fused), and coccygeal (3-5 fused). Key structures include vertebral bodies, intervertebral discs (annulus and nucleus), the spinal canal, nerve roots, facet joints, and ligaments.

Common Diagnoses

Herniated discs range from bulge to sequestration. Spinal stenosis may be congenital, degenerative, or traumatic. Radiculopathy is nerve root dysfunction from compression. Myelopathy is spinal cord compression requiring urgent evaluation. Spondylolisthesis is vertebral slippage.

Surgical Interventions

Options range from conservative treatment to microdiscectomy, spinal fusion, laminectomy, artificial disc replacement, and foraminotomy. Adjacent segment disease following fusion is a major long-term damages consideration with rates of 2-4% per year requiring additional surgery.

Pre-Existing Degeneration Defense

In virtually every spine case, the defense argues degenerative changes caused the symptoms. Counter with evidence of asymptomatic pre-injury status, temporal correlation, mechanism consistency, CACI 3927 aggravation instruction, and the substantial factor test under CACI 430.

Injured your back or spine?

Pre-existing degeneration is not a defense. The law protects you.

Under California law, the defendant takes you as they find you. Pre-existing degenerative changes that become symptomatic after an accident are compensable. Get a free case evaluation.

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Cross-References

Common Questions

Can I recover for a herniated disc if I already had degenerative changes?

Yes. Under California law (CACI 3927), a defendant is liable for aggravating a pre-existing condition. Degenerative disc changes are extremely common in people over 30, even without symptoms. If you were asymptomatic before the accident and became symptomatic after, the defendant is responsible for that change. The defendant takes the victim as they find them under the eggshell plaintiff doctrine.

What is the difference between a disc bulge and a disc herniation?

Radiology uses precise terminology. A disc bulge is a broad-based extension of the disc beyond the vertebral margin, often age-related. A disc protrusion is a focal extension with a broader base than apex. A disc extrusion extends through the annulus with a narrower base. A sequestered fragment breaks free entirely. The more focal and severe the finding, the more likely it is traumatic rather than degenerative.

How much is a spinal fusion case worth in California?

Spinal fusion case values range from $500,000 to $2 million or more for single-level fusions, and $1 million to $5 million or more for multi-level fusions. Values depend on the client's age, pre-injury health, quality of liability, available insurance, and the risk of adjacent segment disease requiring future surgery. A life care planner should project all future costs.

What is adjacent segment disease and why does it matter?

Adjacent segment disease occurs when the discs above and below a fused spinal segment degenerate faster because the fusion eliminates motion at that level, increasing stress on neighboring segments. Studies show rates of about 2 to 4 percent per year requiring additional surgery. This future risk adds significant value to fusion cases and should always be included in life care planning.

Sources & Citations

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Local Resources

  1. CACI 430 — Causation: Substantial Factor. Substantial factor test: accident need not be sole cause of injury.
  2. CACI 3927 — Aggravation of Pre-Existing Condition. Defendant liable for aggravating pre-existing spinal degeneration.
  3. Howell v. Hamilton Meats (2011) 52 Cal.4th 541. Medical damages limited to amounts actually paid or incurred.
  4. CACI 3905A — Physical Pain, Mental Suffering, Emotional Distress. Non-economic damages for chronic back pain and limitations.
  5. CACI 3921 — Lost Earning Capacity. Lost earning capacity from permanent spinal restrictions.
  6. Sargon Enterprises v. USC (2012) 55 Cal.4th 747. Gatekeeper standard for spine expert testimony on causation.