“trauma increase the rate of disc dessication”

How Trauma Can Accelerate Disc Degeneration: A Key Legal Victory

In personal injury cases involving spinal injuries, defendants often argue that a plaintiff’s symptoms stem from preexisting degenerative conditions rather than the accident. This defense strategy can be particularly challenging when medical records reveal evidence of prior degenerative changes. However, a recent New York court decision demonstrates how proper medical testimony about trauma’s effect on disc degeneration can successfully counter these arguments.

New York law recognizes that accident victims with preexisting conditions may still recover damages when trauma aggravates or accelerates underlying degenerative processes. The legal standard does not require plaintiffs to prove they were in perfect health before the accident. Instead, plaintiffs must demonstrate through competent medical evidence that the accident caused a significant change in their condition, transforming asymptomatic degeneration into symptomatic injury requiring treatment.

The distinction between correlation and causation becomes critical in these cases. Defendants routinely submit MRI reports showing degenerative disc disease and argue that plaintiff’s symptoms would have developed regardless of the accident. To overcome summary judgment, plaintiffs need medical experts who can articulate the mechanism by which trauma altered the trajectory of the degenerative process, explaining why symptoms appeared immediately after the accident rather than gradually over time as would be expected from natural degeneration alone.

Case Background

In Giap v Hathi Son Pham, plaintiff Pham sustained injuries in a motor vehicle collision and subsequently sought damages for spinal injuries. During litigation, defendants obtained plaintiff’s medical imaging studies, which revealed degenerative disc changes consistent with age-related wear and tear. Defense counsel moved for summary judgment, arguing that plaintiff’s symptoms stemmed from preexisting degenerative joint disease rather than the subject accident.

The medical evidence presented a common scenario in spinal injury litigation: imaging showing both acute trauma indicators and chronic degenerative changes. Defendants’ motion emphasized the degenerative findings, suggesting plaintiff would have experienced similar symptoms regardless of the collision. This created a burden for plaintiff to explain why the accident, rather than natural progression of preexisting conditions, caused her current complaints.

Plaintiff opposed the motion by submitting affirmations from her treating physicians. These doctors acknowledged the presence of degenerative changes visible on imaging studies but provided critical context: plaintiff was asymptomatic before the accident despite having underlying degenerative joint disease. The physicians explained that while degenerative changes were present, the trauma from the accident aggravated these preexisting conditions and accelerated the degenerative process, causing plaintiff to become symptomatic for the first time.

Jason Tenenbaum’s Analysis:

Giap v Hathi Son Pham, 2018 NY Slip Op 01568 (1st Dept. 2017)

Since plaintiff’s own medical records showed evidence of preexisting degenerative conditions, she was required to address those findings and explain why her current reported symptoms were not related to the preexisting conditions (see Lee v Lippman, 136 AD3d 411 ; Alvarez v NYLL Mgt. Ltd., 120 AD3d 1043, 1044 , affd 24 NY3d 1191 ). To the extent plaintiff’s physicians asserted that plaintiff Pham had degenerative joint disease which was common for her age, that she was previously asymptomatic, that the accident aggravated her underlying degenerative joint disease, and that trauma “increases the rate of disc desiccation,” rendering her now symptomatic, this was sufficient to raise an issue of fact as to causation (see McIntosh v Sisters Servants of Mary, 105 AD3d 672, 673 ).

Legal Significance

The First Department’s decision in Giap establishes important precedent regarding the evidentiary showing required to defeat summary judgment when preexisting conditions are documented. The court rejected a mechanical approach that would grant summary judgment whenever imaging reveals degenerative changes. Instead, the court recognized that degenerative findings alone do not establish causation of current symptoms, particularly when plaintiff was asymptomatic before the accident.

The decision’s emphasis on the statement that trauma “increases the rate of disc desiccation” provides valuable language for plaintiff’s counsel drafting medical affirmations. This formulation explains the causal mechanism linking the accident to plaintiff’s condition: trauma does not necessarily create entirely new pathology, but it accelerates existing degenerative processes, causing structural changes to progress more rapidly than they would have naturally. This accelerated degeneration produces symptoms that would not have manifested but for the accident.

By accepting this aggravation theory, the court acknowledged that New York law does not require plaintiffs to prove pristine pre-accident health. The “eggshell plaintiff” doctrine applies to degenerative conditions as well as other vulnerabilities. Defendants must take plaintiffs as they find them, and the presence of asymptomatic degeneration does not insulate defendants from liability when their negligence transforms that silent condition into a symptomatic injury.

Practical Implications

For plaintiff’s attorneys handling spinal injury cases, Giap provides a roadmap for addressing preexisting degenerative findings. When diagnostic imaging reveals degenerative changes, counsel should immediately obtain detailed medical records documenting plaintiff’s pre-accident status. Evidence showing plaintiff was asymptomatic before the collision—such as absence of prior treatment, lack of complaints to physicians, and full participation in work and recreational activities—becomes crucial in establishing that current symptoms resulted from trauma rather than natural progression.

Medical expert affirmations must specifically address the degenerative findings rather than ignoring them. Generic statements that injuries were caused by the accident will not suffice when defendants highlight preexisting conditions. Instead, experts should acknowledge the degenerative changes, explain that such changes are common and often asymptomatic, and articulate how the specific trauma mechanism in this case aggravated the underlying condition and accelerated the degenerative process.

Defense counsel should recognize that the mere presence of degenerative findings on imaging does not guarantee summary judgment dismissal. To prevail, defendants must do more than point to radiological evidence of degeneration—they must affirmatively demonstrate that plaintiff’s symptoms would have occurred regardless of the accident. This typically requires expert testimony establishing that the natural progression of plaintiff’s degenerative condition, without any traumatic insult, would have produced the same symptomatology at the same time.

Key Takeaway

When facing preexisting degenerative conditions, plaintiffs must provide medical testimony explaining the causal connection between the accident and current symptoms. Expert testimony that trauma accelerates disc degeneration and transforms asymptomatic conditions into symptomatic ones can successfully establish causation, even when defendants highlight pre-accident degenerative changes in medical records.

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