The level of injury, the completeness of the lesion, and the age of the client largely determine the lifetime cost of a spinal cord injury. Those three factors come straight off the medical record — the imaging, the operative note, and the ASIA examination. Herb Borroto, M.D., J.D., reads each one personally. The result is a damages case supported by medicine, not estimates.
The National Spinal Cord Injury Statistical Center estimates roughly 18,000 new traumatic spinal cord injuries in the United States each year. Roughly half of those involve the cervical (neck) spine and produce tetraplegia. The other half involve the thoracic, lumbar, or sacral spine and produce paraplegia. Survival has improved dramatically over the past several decades; lifetime cost of care remains substantial.
Three medical variables shape almost every spinal cord injury case:
The legal case rides on documenting all three carefully — with imaging, surgical records, ASIA exams, and rehabilitation notes — so the lifetime damages presentation is supported by evidence rather than by estimate.
The medical record carries almost all of the weight. Here is how we read it.
CT scout films at presentation. CT myelogram if performed. MRI with T1, T2, and STIR sequences showing cord signal change, hemorrhage, and edema. Post-operative imaging documenting decompression and stabilization. The imaging tells the story of what the cord actually sustained.
Time from injury to surgical decompression. The specific surgical approach (anterior, posterior, combined). Instrumentation used. Intraoperative neuromonitoring data. Whether the cord was found to be contused, lacerated, or compressed at the time of surgery. The neurosurgical operative note frequently has details that the discharge summary does not.
The exam at admission. The exam at 72 hours, when spinal shock has typically resolved. The exam at discharge from acute rehabilitation. The exam at one year, which is the standard endpoint for prognostication. Charting the ASIA scores over time documents the actual recovery trajectory.
Pressure ulcer risk and prevention. Autonomic dysreflexia management for cervical and high thoracic injuries. Neurogenic bowel and bladder management. Spasticity treatment. Heterotopic ossification. Each one has its own equipment, medication, and care requirements that drive lifetime cost.
Power wheelchair replacement cycles (typically five to seven years). Mattress and seating systems. Vehicle modification and replacement. Home accessibility modifications. Attendant care hours. Medications. Bowel and bladder supplies. Each line item is sourced and audited against what trauma medicine and rehabilitation science actually project.
Board Certified Civil Trial Lawyer (NBTA). A spinal cord injury case demands trial preparation because the lifetime damages are large enough that the defense will fight every line of the life care plan. The credibility of the firm willing to try the case shapes what the resolution looks like.
Leading cause. High-energy crashes producing flexion-extension injury, burst fractures, and direct cord trauma. Cervical spine is the most commonly injured level.
Second most common. Falls from elevation typically produce thoracolumbar fractures with cord compression. Ground-level falls in older adults can cause central cord syndrome and incomplete tetraplegia.
Disproportionate force on the cervical spine. High rates of complete injury. Often paired with TBI and other polytrauma.
Diving into shallow water, football tackles, equestrian falls, mountain biking, skiing. Roughly 8% of spinal cord injuries nationally.
Gunshot wounds are the most common. Premises liability claims arise when assaults occur on commercial property with inadequate security and the property owner could have prevented the foreseeable harm.
Falls from elevation, struck-by hazards, machinery accidents. Third-party claims against general contractors, equipment manufacturers, and on-site companies frequently run alongside worker's compensation.
Failure to maintain spinal precautions in trauma intake. Surgical positioning injuries. Anesthesia complications causing cord ischemia. Failure to recognize and decompress an evolving cord injury.
Defective seatbelt restraints, roof crush in rollover, defective safety equipment, defective machinery. Product liability claims expand the legal theory and the available coverage.
Delays in surgical decompression beyond the recognized window. Failure to administer or maintain appropriate steroid protocols where indicated. Missed evolving deficit on neurologic exam. The acute-care decisions affect the long-term outcome.
Spinal cord injury cases produce some of the largest damages presentations in personal injury law because the lifetime cost of care can be enormous. Categories typically include:
Quadriplegia and tetraplegia mean the same thing — paralysis affecting all four limbs, caused by spinal cord injury at the cervical (neck) level. “Tetraplegia” is the term preferred in modern medical literature; “quadriplegia” is still the more common term in everyday use. Paraplegia means paralysis affecting the lower limbs, caused by spinal cord injury at the thoracic, lumbar, or sacral level. The functional difference is significant: a person with paraplegia retains use of the arms and hands; a person with tetraplegia does not.
The ASIA Impairment Scale, developed by the American Spinal Injury Association, classifies spinal cord injury severity from A (complete) to E (normal). ASIA A — complete injury, no motor or sensory function below the injury level. ASIA B — incomplete, sensory function preserved but no motor. ASIA C — incomplete, motor function preserved but more than half the key muscles below the injury level are weaker than grade 3. ASIA D — incomplete, motor function preserved with most key muscles at grade 3 or better. ASIA E — normal motor and sensory function. The ASIA classification at the time of injury, and again after the acute phase, is the single most important predictor of long-term function and lifetime cost of care.
The National Spinal Cord Injury Statistical Center reports that motor vehicle crashes are the leading cause of traumatic spinal cord injury in the United States, accounting for roughly 38 percent of cases. Falls are second, at about 32 percent. Acts of violence (most often gunshot wounds) account for around 14 percent, and sports and recreation about 8 percent. The remainder are caused by medical and surgical complications, workplace incidents, and other mechanisms. The mechanism shapes the medicine: high-energy crashes typically produce burst fractures with cord compression; falls typically produce compression fractures with retropulsion.
Herb Borroto, M.D., J.D., personally reviews the imaging and the operative record. The cervical and thoracolumbar films at presentation. CT angiography if vascular injury is suspected. MRI showing cord signal change, hemorrhage, or edema. The neurosurgical operative note documenting the decompression and stabilization. The serial ASIA examinations during the acute and rehabilitation phases. The rehabilitation team's discharge summary. The medicine establishes the mechanism, the injury severity, and the prognosis — which together drive the damages presentation.
It depends on the level and completeness of the injury and on the age at which the injury occurred. Lifetime cost varies enormously between, for example, a high cervical tetraplegia in a 25-year-old (the most expensive scenario in trauma medicine) and a low paraplegia in an older adult. A life care planner builds a detailed projection of every medical, equipment, attendant care, and home modification cost the client will face over their lifetime. An economist reduces it to present value. Herb Borroto audits the life care plan to make sure every category is included — surgical revisions, urological complications, pressure ulcer care, equipment replacement cycles.
Statutes of limitations vary by state and by the underlying cause of action. Personal injury statutes typically range from two to four years. Claims against government entities require pre-suit notice within months. Medical malpractice claims have their own pre-suit procedural requirements. We evaluate each case under the deadline that applies to the state where the injury occurred. Call as soon as possible — preserving evidence and securing the early medical record before the acute phase ends materially helps the case.
Herb Borroto reads the imaging and the ASIA exam. Alex Alvarez maps the legal case. No cost. No obligation.
The leading cause of traumatic spinal cord injury.
Disproportionate force on the cervical spine.
High rates of complete cervical injury.
Spinal cord injury in a rideshare crash invokes the tiered insurance structure.
Falls are the second leading cause of spinal cord injury.
High cervical injuries with respiratory failure carry significant mortality.
Frequently co-occurs with cervical spinal cord injury.
Crush injuries that produce both cord injury and limb loss.
Every catastrophic injury case type we handle nationwide.
