Illustrated Medicine: Case Study

Trauma-induced sciatica

This 50 year-old seat-belted driver was rear-ended at highway speeds. He suffered a lumbar spine sprain/strain injury.

Purpose of illustration
This illustration exhibit was created to demonstrate the direct anatomical link between the trauma-induced L4-5 disc herniation diagnosed post-accident, and the resultant painful sciatica symptoms of shooting burning pain into his buttock and down his leg, making it difficult to stand and walk.

Rationale for litigation exhibit
Mr. Smith had previous surgery in this area and was susceptible to further injury. The jury needed to appreciate: details of the injured disc with herniation resulting from the impact forces; associated impingement of the L4 nerve root component of the sciatic nerve; and the resultant pain that radiated through his lower back and into his left lower limb in the L4 dermatome pattern.

The L4-5 disc underwent further degenerative changes. Mr. Smith had several injections for pain, and surgery was eventually required.

Other visuals demonstrated 
Additional illustrations showed: details of the mechanism of injury; an overview of how disc herniation progresses to the point of nerve root impingement; and the associated decompression surgery that was performed.

The case settled immediately before trial was to begin.