A Systematic Approach to Clinical Determinations of Causation in Symptomatic Spinal Disk Injury Following Motor Vehicle Crash Trauma

This article presents a literature review of the current literature on causation, causal determinations after trauma and intervertebral disk (IVD) injury after a motor vehicle crash (MVC). From this, the authors develop a practicable, logical, and literature-based approach to causation determinations of symptomatic IVD injury after MVC. They note that clinical determinations of causation in cases of intervertebral disk (IVD) injury after a motor vehicle crash (MVC) are often disputed in medicolegal settings. The results of the review indicate that IVD injury can result from any MVC regardless of magnitude, thus meeting the first criteria of causation, biologic plausibility. Individual determinations of causation depend entirely on the temporal association between the collision and the symptom onset (the second criterion) and a lack of a more probable explanation for the symptoms (the third). When these three causal elements are met, clinicians can assert causation on a “more probable than not” or “reasonable probability” basis. Because of a lack of an established or reliable relationship between collision force and the probability of IVD injury the investigation of collision parameters is not a useful adjunct to causal determinations.

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  • Supplemental Notes:
    • Abstract reprinted with permission from Elsevier.
  • Authors:
    • Freeman, Michael D
    • Centeno, Christopher J
    • Kohles, Sean S
  • Publication Date: 2009-10


  • English

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  • Accession Number: 01150367
  • Record Type: Publication
  • Files: TRIS
  • Created Date: Jan 30 2010 11:05AM