[Long]

#6230

Hello Dr. Corenman: Excellent You Tube videos. You really know your stuff.

I would really appreciate if you could answer 2 questions.

1. How can you tell on an MRI of the lumbar spine a new herniation (w/i 6 months) versus an older herniation?

2. Biomechanically, how can can a lumbar herniation be caused in a side or rear end automobile collision?

I would be happy to pay you for your time if you’d like, and welcome your direction to any reference materials that you could recommend.

Thank you. Gavin Long

949-752-2999

[Donald Corenman, MD, DC]

#6233

MRIs are not very good at specifically dating an injury. There are some changes that are time dependent but some defy identifying the date of origin. The most common way to date an injury is to compare to an old MRI. With a disc herniation, the MRI needs to be combined with the patient history to be able to ascertain date of injury.

Lumbar disc herniations occur with motor vehicle accidents. Normally, with any herniation, there is preexisting degenerative changes. It is rare that a normal disc herniates (exceptions: fall from height, MVA vs. pedestrian). The forces generated by a substantial impact can torque the lower discs and tear the remaining fibers of the annulus to cause a herniation. This is more commonly seen with a patient that does not wear a seat belt.

Dr. Corenman

[Author]

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