Atlanta Injury Law Blog

As an injury lawyer in Atlanta, I have dealt with probably thousands of cases of back injuries involving ruptured or bulging intervertebral discs pressing on nerves and causing pain in the back as well as pain, numbness and tingling radiating down arms and legs. This is probably the single most common injury we see resulting from motor vehicle collisions.

Now an Australian biotech company has announced successful preclinical trial results of its adult stem cells in the treatment of degenerative intervertebral disc disease, the leading cause of low back pain. Note that they are using adult stem cells, not the controversial embryonic stem cells.

It's a long road from preclinical trials in Australia to FDA approval in the US.  But if this turns out to be a practical treatment for damaged discs, it could be a major breakthrough for treatment of millions of people with injured and/or degenerative disc problems.

While I make my living as a trial attorney handling personal injury liability cases for people who have been seriously injured, I am also deeply interested in scientific advances that improve their prospects for productive lives of high quality.

Traumatic spinal cord injuries leading to quadriplegia and paraplegia are among the most devastating of all physical injuries.  The full scope of problems associated with those conditions  -- pressure sores, spasticity, autonomic dysreflexia, lack of bowel and bladder control, etc. --  is unknown and virtually unimaginable to anyone who has not dealt directly with those conditions.

New advances in stem cell and nanotechnology research appear to offer hope in the long term. However, they are a long way from producing  treatments approved by the FDA, clinically available in the US and paid for by health insurance. Stem cell studies with lab animals have produced exciting reports, and every few weeks I see hopeful reports about the prospect of using stem cells from olfactory nerve, umbilical cord blood, spleen or bone marrow.

There is a lot of hype about the promise of stem cell therapies, and we read of patients traveling to Portugal, China, Thailand or Mexico for cutting edge treatments, the efficacy and safety of which have not yet been proven to the satisfaction of US authorities. 

A few web sites that offer insights into the current state of stem cell research are:

• Harvard Stem Cell Institute
• Stem Cell Challenges in Biology and Public Policy by Douglas Melton
  
• Understanding Stem Cells: An Overview of the Science and Issues from the National Academy of Science
• National Institutes of Health Stem Cell Information
  
• Stem Cell Research and Applications
  
• Stem Cells in Biomedicine
  
• International Society for Stem Cell Research
  
• Stem Cell Books
  
• Embryonic Stem Cell Basics
  
• Tell Me About Stem Cells
  
• StemCellResources.org
  
  

 I'm not a physician and cannot give medical advice. In representing victims of catastrophic injury, however, we try to look ahead to the possibilities for improving the quality and quantity of life if sufficient financial resources are made available.

For patients with low back pain and other symptoms caused by herniated discs, surgery provides better results than nonsurgical treatment, according to a study in the December 1 issue of Spine.  In the 4-year combined as-treated analysis, those receiving surgery demonstrated significantly greater improvement in all the primary outcome measures.

That research report doesn't surprise me.  Over the years I have represented many clients who had herniated discs due to back injuries in various sorts of accidents. While there are stories of medical success and failure in both surgical and nonsurgical approaches, the general pattern of outcomes has led me to develop a bias in favor of decisive action without excessive delay.

Personal experience contributes to that. bias In 1990, I developed a herniated disc in the lower back at L5-S1, probably due to delayed effects of a car wreck a few years earlier combined with the strain of sprinting at an airport with about 100 pounds of what lawyers jokingly refer to as "briefcases."  Though the pain was immediately excruciating, I had a case to try  a few weeks later and was too stubborn to deal with my own medical issue til we got our judgment ($1.75 million).  For a  month I worked through constant pain that was like boiling oil pouring down the back of my right leg,  Then, on Sunday after completion of the trial on Friday, I woke to find that the pain had stopped, but I had lost most use of my right leg. 

Fortunately, I had a connection with one of the top neurosurgeons practicing in Atlanta at that time, Dr. Nettleton Payne.  He saw me on short notice, an ordered an MRI that showed "all the jelly was out of the donut."  That meant there was nothing to do but operate, so I didn't have to endure months of conservative therapy.  Fortunately, Dr. Payne had a brief opening in his schedule later that week, prior to catching a plane to surprise his son who was cycling across the continent.  Dr. Payne performed a discectomy without fusion.

Within two months after surgery I was jogging a little. Within six months I had ceased to have pain or tingles down my leg.  Eventually I ran marathons with no difficulty related to the back -- though a general lack of athletic aptitude and inadequate training led to poor marathon times. Now it has been 18 years since I had low back pain other than an occasional muscle strain.

My personal experience and most of the experiences reported by personal injury clients over the years is consistent with the report in Spine, that for low back herniated disc injuries, surgical outcomes generally beat nonsurgical outcomes. However, inidividual results do vary. Not everyone has a surgeon as skilled as I did, and individual injuries to differ.

While I  had a good outcome with my own herniated disc, I have also experienced the painful and debiliatating effects of the injury.  These professional and personal experiences have proven helpful to me in proving the impact of back injuries and optimizing monetary recovery for clients who have such injuries.