More and more people are aware of the concern around delayed onset injuries, and for good reason. A slight soreness in the immediate aftermath of an accident can easily be much more severe than we realize at the time. Shock and adrenaline are what the body uses to mask pain, and they provide an important ability for humans to persevere through times of stress and emergency. The downside of these reactions is that we may not be aware of the extent or severity of our injuries. Therefore, it is incredibly important to get medically checked out after an accident, even if you don’t believe you are hurt. One such accident impact injury that is frequently misdiagnosed, or altogether missed, can be very serious, and that is Loss of Motion Segment Integrity (LMSI).
What is Loss of Motion Segment Integrity?
Loss of Motion Segment Integrity is the loss in range of motion or movement beyond normal limits in the flexion and extension of two adjacent vertebrae. The condition is dangerous for surrounding areas which are prone to overexert and overextend in compensation for the area with the loss. The condition and its guidelines for recognition and diagnosis are codified by the American Medical Association (AMA). It happens through traumatic impact injuries, such as car and truck accidents, falls from heights, or other whiplash-inducing events.
Most commonly, the condition occurs in the cervical area of the spine (roughly the neck), but it can also occur in the thoracic or lumbar spine (middle or lower back, respectively). LMSI can cause significant, and even permanent reductions in a patient’s health status. This is particularly true if the condition goes undiagnosed and untreated.
What does LMSI feel like?
There is variation in patient experience of this injury, tied to acuteness of the LMSI itself, and the location of the stress in the spine. In chiropractic discourse, LMSI is considered a Level IV injury, which is very painful. According to hierarchies of injury severity and pain in the discipline, LMSI is “comparable to a 50 percent or greater vertebral compression fracture that has no residual neural compromise.”
In relative terms of injury, ligament and disc injuries can be comparably painful. They can also be complex to resolve, and as much an art as a science to heal, because treatment requires a careful combination of rest, stretching, and strengthening activity around the damaged region to build stability and flexibility.
What is AOMSI?
AOMSI stands for Alteration of Motion Segment Integrity. Alteration of Motion Segment Integrity can be either loss of motion segment integrity (increased translational or angular motion) or decreased motion secondary to developmental fusion, fracture healing, healed infection, or surgical arthrodesis. It is one of the most severe categories of accident injury. Particularly when the injury occurs in the back, the trauma to the spine is extremely serious. It is rated at a 25% impairment rating by American Medical Guidelines because studies have shown that within the next 5 years patients will have degenerative disc disease. This impairment rating makes AOMSI comparable to injuries such as amputations and fusions. Chiropractic research in many ways pioneered the guideline development and technology related to AOMSI. Much of the research on this injury, and motivation for continued study, stems from chiropractic and sports medicine practices.
The LMSI Problem: Misdiagnosis
Why is LMSI Frequently Misdiagnosed?
There are a few key reasons that LMSI is often misdiagnosed or altogether missed. First, the human eye cannot detect AOMSI (or LMSI), leading to it being missed in an estimated 45% of cases. Secondly, individuals may not seek medical attention for it. The problem can occur in delayed onset after a crash, so that the patient doesn’t recognize the initial cause of the LMSI, or they may feel that it’s not so serious due to the delay in feeling symptoms. Finally, symptom overlap between LMSI and more standard strains or sprains has traditionally led medical practitioners to dismiss the possibility. They may instead assume the patient is dealing with only a more common minor soft tissue injury based on the limited range of motion, tenderness, etc.
How Is LMSI Diagnosed?
Diagnostic requirements for LMSI are very strict. Due to the very specific changes to range of motion in the vertebrae that define the condition, measuring it requires highly advanced equipment and software that achieves accuracy to within 0.01 mm and 0.01 degrees. The resulting imaging must be examined by board-certified radiologists for acceptable diagnosis. Imaging is done through radiographic flexion extension study. This often includes static flexion and extension x-rays of the cervical spine, or more commonly, a digital motion x-ray (DMX). In the past DMX was more commonly referred to as the study of which it is a derivation: Fluoroscopy. Essentially, the process is that of taking a moving x-ray image to examine and measure the motion of the body part.
What Does an Accurate Diagnosis of LMSI Mean for You?
There are two major reasons that these exacting methods of diagnosis are essential. First and foremost, your healing and recovery are only improved by the greatest accuracy and specificity of diagnoses. Secondly, an LMSI diagnosis has significant implications for your insurance claim and case.
Your Healing – LMSI has been tied to degenerative disc issues, if you aren’t aware and taking corrective action from the time of injury, you risk exacerbating these injuries. It’s important to stretch and strengthen the musculature around the point of LMSI injury to help heal and teach the body to repair the damaged area. With misdiagnosis, you are at greater risk of compounding injuries. If you don’t know that you have LMSI and you proceed with normal activities as if you are just nursing a minor soft tissue injury, like a sprain, this behavior could really push the damage to a point of further, or even irreversible, injury. Compounding injuries such as these have resulted in cases of paraplegia.
Your Claim – Insurers are dismissive of LMSI without certain and specific thresholds of confirmation. They may deny that is the extent of the injury and argue that you have only a soft tissue injury. Their motivation to do this is because a soft tissue injury carries a much lower claim value. LMSI injuries are in compensation ranges many times greater. When LMSI is diagnosed and proven through inarguable methods, it is highly effective in insurance negotiations and in court. This is due to degree of accuracy that contemporary diagnosis methods allow. Insurance companies hate a confirmed LMSI diagnosis because it is virtually irrefutable, and it is expensive for them. However, if you have suffered LMSI, you are dealing with a serious health and healing challenge. You deserve those settlement funds for your compensation.
Call Thompson Law for Help After LMSI
Have you recently experienced a car or truck accident, slip & fall, or perhaps a workplace injury? If you or someone you love is experiencing aches and pains from an impact injury in an accident, it’s incredibly important to seek medical attention and treatment. LMSI is commonly mistaken for run of the mill strains and sprains, but left undiagnosed and untreated, they can have major consequences for patients’ future health and mobility.
If your injury was a result of the negligence of someone else, it’s also important that you speak with an accident attorney about your rights and your options. Suffering pain, losing time and wages from work, or facing lifelong physical hardship through no fault of your own is an injustice. You deserve compensation for the losses and the hardship you’ve suffered. Cash payment may never make up for the injuries that result from car accidents or other dangerous accidents, but it can significantly help with handling the resulting bills, property damage, healthcare, and family challenges that follow.
You deserve skilled, experienced, and caring help after a serious injury or LMSI. Call Thompson Law for assistance anytime. 24 hours a day, 7 days a week, 365 days a year, we are here for you.
If you found this article helpful, you may also like:
How is Someone’s Quality of Life Impacted by Spine Surgery?
Get Necessary Medical Care After Your Accident
Types of Car Accident Injuries
The State of Texas has a statute of limitations of two (2) years for personal injury cases, so if you have suffered after being hurt in a car accident, consult with an experienced personal injury attorney. The sooner you know your options, the sooner you are on the path to recovery and your deserved compensation. However, delayed onset injuries are no less deserving of justice. If you’ve been hesitating to reach out, don’t delay any further. Call Thompson Law right away for assistance with your injury and claim.