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Dr. Gary Kraus
Applying Science to the Art of Medicine
Applying Science to the Art of Medicine


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Non-surgical and Minimally Invasive Surgical Treatment of Low Back Pain and Neck Pain.  Conditions treated include herniated disc of the low back and neck, spinal stenosis, compression fractures of the spine, spondylolisthesis and spondylosis.
Call us at 281-713-6296

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Automobile Accidents, Truck Accidents, Car Accidents and the Spine

Automobile accidents, arising from motor vehicle injuries or truck accident injuries, are the most common source of new spinal cord injuries, accounting for roughly 35% of new injuries in a given year. Unfortunately, the nature of automobile and other motor vehicle accidents’ (including motor vehicle injuries and truck accidents) effects on patients is inherently unpredictable: the extent of the spinal cord injury depends upon the types of vehicles involved, how fast they were moving, which direction they were traveling at the point of impact, and a variety of other mechanical factors, not to mention the age and physical health of the vehicles’ passengers. Quick changes in direction (much faster than the body is normally subjected to) with massive inertial forces behind these changes can cause serious trauma within the spinal column. The body adjusts well to its own changes in direction, but when these large external forces act on the body, they can cause what is commonly known as whiplash: the body’s cervical facet joints are hyperextended from the initial impact, then they “whip” back as the reactive force comes through, which can cause inflammation and severe pain, as well as permanent damage to spinal anatomy including discs, vertebrae, and spinal nerves.

Whiplash isn’t the only possible cause for injury to the spinal column during automobile accidents, however. Those same enormous forces resulting from the impact can crush parts of the spinal column, fragmenting vertebral bone and disc material. These cases are particularly dangerous, because if these shards pierce the walls of the spinal canal (the membraned structure that runs most of the length of the spinal column and houses the major tracts of spinal nerves), these nerves can suffer irreparable nerve damage. We depend on functional spinal nerves for interpreting fundamental motor control signals sent by the brain, as well as interpreting sensory data collected from other parts of the body. The spinal nerves sometimes cannot heal themselves if they are damaged, often meaning that a spinal cord injury has drastic negative consequences for a patient’s long-term mobility. Whiplash, paralysis, numbness, weakness, pain, deformity, and bowel and bladder problems are all potential consequences of spinal injury resulting from automobile accidents and from truck accidents. Paralysis may occur focally in a limb, if the nerves to a limb are injured or severed. Paralysis can also occur when the spinal cord itself is severely injured. Bowel and bladder dysfunction may occur when there is damage to the spinal cord.

Fortunately, many injuries sustained during automobile accidents, whether they be car accidents or truck accidents, may be successfully rehabilitated with spinal physical therapy, with the caveat of no permanent damage to the spinal nerves. As long as patients retain motor control, the long-term prognosis at maintaining their mobility through regular spinal physical therapy and spinal injury rehabilitation exercises is quite good. These exercises focus on re-building range of motion, flexibility, strength, and endurance, re-stabilizing the spinal column by core strengthening all the core muscles along the spine and throughout the torso. Once patients complete a spinal physical therapy program, they are advised to continue the exercises indefinitely in a home setting in order to maximize benefits to their long-term mobility.

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The Spinal Column during a Spinal Injury review

Though it is less flexible than many of its mammalian counterparts, the human spinal column is normally a durable structure capable of a wide variety of movements. During a spinal cord injury, however, everything can change as a patient’s long-term mobility is threatened. The spinal canal houses the spinal nerves and runs most of the length of the spinal column. During a spinal cord injury, sometimes the trauma is forceful enough to propel shards of vertebral bone or spinal disc material through the walls of the spinal canal and threaten the integrity of the spinal nerves.

Spinal cord damage is perhaps the most serious consequence of a spinal cord injury, given that we depend on the spinal cord to function properly in order to interpret sensory data (touch, pain, heat, cold, etc.) as well as to relay motor control signals from the brain. The spinal cord also has no native regenerative capacity, meaning that it cannot heal from physical trauma. Even bruising the spinal cord can be enough to permanently reduce a patient’s mobility. Sometimes, depending on the extent of the bruising and the age and physical health of the patient, mobility may be regained after the initial inflammation subsides.

Following the accident, assessing the full extent of the damage becomes doctors’ first priority as they attempt to find an effective course of treatment. Oftentimes back spine surgery is necessary in order to remove portions of vertebral bone or herniated disc material that may be threatening other spinal nerves. If the nerves themselves are damaged, patients may experience muscle weakness, numbness, and permanent mobility loss. Extensive long-term physical therapy is also necessary in order to keep the patient’s range of motion from decaying.

Automobile accidents, including major or minor motor vehicle accidents, as well as truck accidents, and falls, may commonly cause compression fractures, during which the spinal column experiences forces which crush vertebral bone and disc material. Depending on the direction of the forces, the spinal column may be contorted in a wide variety of ways. This makes predicting the extent of injury quite difficult, which is one of the reasons why first responders typically set about immobilizing the patient as soon as possible in order to minimize the possibility of further damage. Though compression fractures within the spinal column can definitely cause long-lasting damage, doctors can sometimes minimize permanent mobility loss if they are able to access the patient in a timely manner. Ultimately, a patient’s long-term mobility prospects rest with the extent of the damage to the spinal nerves. Medical researchers will continue their work to imbue the spinal nerves with regenerative capacity in the coming decades.

Patients may need the assistance of physicians to deal with the medical issues, and lawyers / attorneys who specialize in personal injuries, such as motor vehicle accidents or truck accidents.

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Spinal Injury Lawyers and your Health Insurance 

Patients may have been involved in a motor vehicle accident, truck accident, or other type of motor vehicle injury.  Of course, any type of injury, whether it be a motor vehicle injury, truck injury or car injury, are unplanned, and can have significant consequences for the injured person.  Understandably, most spinal injury patients are often much more concerned with their long-term prospects for rehabilitation and recovery. As the claim process progresses, it’s easy to let financial decisions take a back seat to quality care. The unfortunate reality, however, is that your health insurance coverage benefits may not cover your recovery in all the ways you require. It’s advised that spinal injury patients take the time to understand their coverage as best they can in order to search for the local and regional doctors that will make a physical and financial recovery possible. After all, whenever the spinal nerves are involved, costs can quickly run to the tens and even hundreds of thousands of dollars. Many patients need corrective spine surgery to remove or repair damaged portions of the spinal column (fragments of disc or vertebra, for example) in order to minimize the possibility of further damage, or to re-stabilize the spinal column. 
Patient advocates are also excellent sources of information, especially when it comes to evaluating how your health insurance coverage will affect your recovery. These laypersons specialize in knowledge regarding the healthcare industry and will likely be able to point you in the direction of doctors (and even other patients) who can give you more advice about how to proceed. For most patients, finances are a high priority, so patient advocates may attempt to put you in touch with in-network healthcare services, depending on your health insurance provider. 
Remember that the long-term goal of any spinal injury recovery is to maximize your quality of life. If you need to switch health insurance providers or go with a more expensive treatment, keep that information in mind. It’s hard to ignore large costs, but remember that certain treatments may make the difference between large discrepancies in your long-term mobility. Independent living may still be possible depending on the location and severity of your injury. Though permanent back pain will likely still rear its ugly head, patients can take solace in the fact that most health insurance companies reimburse at least partially for spinal physical therapy, particularly in severe cases like spinal injury. 
Spinal physical therapy will help in decreasing back pain by building up muscles throughout the torso and spinal column, allowing patients to explore the limits of their mobility to make sure that their range of motion does not deteriorate further during recovery. Be aware that some health insurance companies may not reimburse you for physical therapy treatments beyond a certain time after your accident, so if possible put your emphasis on programs with exercises simple enough to learn and perform in a home setting. Depending on the severity of your injury, you may also need an assistant to help with maintaining blood flow to areas which fall below the point of your spinal injury. If you have permanent mobility and / or sensation loss, remember that keeping those desensitized areas exercised is vital to avoiding dangerous complications like blood clots.

note: for personal advice, consultation with an attorney is recommended

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Frequently Asked Questions Regarding the Legal Aspects of Spinal Injury

Perhaps one of the most common questions asked in the wake of a spinal injury is: where do I begin? Dealing with newfound immobility can be traumatizing, and patients generally have a long road of healing, recovery, and physical rehabilitation ahead of them with no guarantees of recouping the mobility they may have lost. Family members and friends of the patient should work on organizing legal counsel for the victim. Be forthcoming with all the details of the accident. Personal injury lawyers need to have all the pertinent facts of the case in order to have the best chance at reaching a settlement for the patient.

Many spinal injury patients may understandably be concerned with the financial aspects of their recovery. After all, healthcare in the US is remarkably expensive relative to many other first-world nations, and spinal injuries necessitate a variety of expensive treatments, especially if the patient’s mobility has been permanently compromised. Fortunately, most personal injury lawyers work on a contingent fee basis / contingency , meaning that they only receive compensation if they are able to secure a claim for the patient. Otherwise, the patient is not responsible for compensating their services. If a settlement is indeed reached, however, the patient does not receive the full amount. His or her lawyers are then compensated for their services from the settlement. Even with a contingent fee basis / contingency, the patients may be responsible for other legal fees depending on their locality and circumstances of their injury. Most cases are handled on a contingent fee basis / contingency, and fee for service is infrequently used.

Costs do not end there, however, especially if the patient has experienced a permanent injury. Long-term physical therapy and rehabilitation are often necessary to make sure the patient’s mobility does not undergo further decay. Patients may experience extremely sharp back pain during the first few months of post-operative care, since traditional back surgery involves long, deep incisions that take months to heal completely. The extent of the surgery will of course be dependent on the severity and location of the patient’s injury. Back pain will also fluctuate depending on if the spinal nerves were permanently damaged. Normally, the spinal nerves serve as pathways for motor control signals from the brain, as well as helping the body to interpret external stimuli (pressure, heat, cold, pain, etc.). If the injury damages the spinal nerves, they do not recover, since they have no native regenerative capacity. In these cases, patients may lose partial or total sensation below the point of injury, which minimizes back pain but obviously causes much more serious problems with long-term mobility.

note: for individual advice, consultation with an attorney is suggested

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The Legal and Ethical Aspects of a Spinal Injury

Spinal injuries present difficult decisions to all parties involved. Patients must decide how to best file a claim for compensation, which is a decision not taken lightly, especially if the patient is struggling with major back pain and a downgraded quality of life as a result of the accident. Patients are advised to pursue a full medical examination to corroborate their evidence for a potential claim, given that settlements are typically decided based on how much the spinal injury in question has changed the patient’s quality of life. Doctors will perform range of motion tests as well as interpreting data from numerous imaging exams (x-rays, magnetic resonance imaging) in order to evaluate the patient’s possibilities for long-term recovery.

If the spinal nerves are damaged, however, patients generally stand to receive some sort of financial compensation, since the spinal nerves lack native regenerative capacity. When they receive sufficient trauma, they are no longer capable of performing their normal functions: interpreting sensory data from external stimuli as well as motor control signals from the brain. Patients with damaged spinal nerves face an increased likelihood of permanent paralysis, usually losing control and sensation at or below the point of the spinal injury.

It’s extremely important that patients remain honest and forthcoming with their legal and medical representatives during the claim process. Consider consulting patient advocates (laypersons who specialize in knowledge of the healthcare industry) for extra information regarding how health insurance companies influence the process. Patients need to be very familiar with their own health insurance coverage plans and motor vehicle insurance plan, especially if they intend to pursue a claim.

When searching for a legal representative, keep in mind that most spinal injury / personal injury lawyers work on a contingency fee basis, which means that they receive compensation only if they are successful in reaching a financial settlement for their clients. This means that any compensation due is then subtracted from the settlement in order to compensate the personal injury lawyers for their services. Patients can take solace in the fact that these law professionals and other patient advocates will work extremely hard in order to maximize such awards. Even with a contingency fee basis in place, however, patients still need to provide solid medical evidence that supports their claims regarding limited mobility. If the patient is subsequently found to have recovered much or even all of his or her movement, it’s highly unlikely a significant settlement will be reached.

note: for individual legal advice, consultation with an attorney is advised

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Filing a Claim for a Motor Vehicle Accident Spinal Injury

Filing a claim in pursuit of a settlement for a spinal injury can feel overwhelming, especially if the patient doesn’t have much experience dealing with legal matters. Typically, the patient is left to pursue a settlement from a larger body, usually an insurance company, and if the injury is related to a motor vehicle accident, the determination of fault, and obtaining compensation for injury, may turn into a legal issue. This makes the legal component of the case quite delicate, and patients are recommended to consult with an injury attorney who specializes in motor vehicle injuries, specifically spinal injury. This added experience will allow the personal injury lawyer to take advantage of motor vehicle accident and truck injury laws of which other law professionals may not be aware.

Usually, spinal injury claims involve personal injury lawyers working on a contingent fee basis, which means that the patient’s lawyers are not compensated unless the patient wins a settlement. When a settlement occurs, the personal injury lawyers are then compensated from the final settlement amount. This is partially the reason why patients should be punctual, forthcoming, and detailed when it comes time to describe the circumstances of their spinal injury and any recurring back pain, as well as how the injury has changed their day-to-day life. The lawyer depends on that specific knowledge in the course of filing a claim, since the settlement amount for injury claims is largely based on how much the injury has changed the patient’s life for the worse. Patients will need to provide extensive medical records (doctor’s consultations, imaging tests, etc.) in order to corroborate their evidence of the injury’s effects.

Patients may also wish to consult outside sources for help in proceeding with the claim of a motor vehicle accident. Patient advocates can be an invaluable resource for back pain patients in learning how to better describe their back pain, as well as evaluating additional routes for treatment. Patient advocates are laypersons who specialize in knowledge about specific areas of the healthcare industry, particularly how large health insurance companies interact with their local communities on a personal level. These advocates can help patients make sense of their injuries as well as their coverage plans and also may be able to give local recommendations for legal counsel. Patients can then use this information to help their position when filing a claim. Essentially, if the patient’s lawyers have verifiable proof of the patient’s condition as well as the circumstances of their spinal injury, the patients stand an excellent chance at reaching a settlement. The financial remuneration may then be used to further treatment for the patient.

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Finding an Attorney for your Spinal Injury

If you are experiencing lingering back pain and / or your quality of life has suffered because of a spinal injury, you may wish to consider finding an attorney to represent you in a court of law, especially if the injury occurred on your employer’s property. Many people hesitate to pursue claims for a variety of reasons, including fear for their jobs as well as their own personal health, yet larger companies often have legal teams whose sole function is to absolve the company of liability in these specific situations. Finding an attorney becomes essential if the patient wants to use the law in order to secure compensation for injury.
Yet how does one find an attorney for legal representation to help obtain just compensation, specifically one that specializes in spinal injury? First, understand that such specialization for legal representation generally means the lawyers best suited to your case will be located in larger population centers. Attorneys dealing in legal representation in smaller towns, while proficient in their own right, may have to widen their expertise to ensure they have regular income. Always make sure that your attorney specializes in cases similar to yours, and can help to obtain the compensation to which you may be entitled. Make inquiries about the attorney’s fees, case history, and local operations. Word of mouth can be an excellent reference here. If you know others who have pursued injury claims to obtain appropriate compensation, ask them for legal references and general advice about how their cases were handled. Many legal firms also now host testimonials from former clients on their websites. If you can establish a connection with any of these former clients, ask them specific questions about their conditions as well as how the claim process proceeded. In addition, online legal forums are a great resource here. Though the experiences of clients’ legal representation in other localities may vary, all share the common experience of pursuing a spinal injury compensation claim, generally against a larger opponent. Legal forums can be a great resource in developing one’s claim.
Back pain patients can also pursue patient advocates in order to gain further knowledge about how their condition interacts with their health insurance providers. Patient advocates are laypersons with a wealth of information regarding specific areas of the healthcare industry. Generally, patient advocates help patients learn more about how to get the most out of their employer-based health insurance coverage plans, but they may also be able to provide information for back pain patients recovering from a spinal injury, specifically regarding which local attorneys may be best suited to the job. If you have local patient advocates, be sure to take advantage of their surfaces, especially if you are feeling confused at how to proceed with your claim.

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Spinal Injury, Personal Injury Truck Injury Lawyer and the Law

Motor vehicle accidents involving cars and trucks are, unfortunately, quite common. When a collision / motor vehicle accident occurs between a car and another car, or between a car and a truck, significant damage may occur to the passengers as well as to the vehicle. Before anything else, protecting life and health is the most important. Once this is accomplished, there is the reality of dealing with the damages to one’s own health, and any bodily injuries they may have suffered. There may be minor bruises and scrapes, or more major bodily injuries, or spinal injuries / back injury. Frequently, at the scene of the accident, it is not clear to the accident victim as to how severe bodily damage may be. For that reason, when the ambulance arrives at the scene of the accident, it is often a good idea to be taken to the nearest hospital emergency room, for evaluation. Many times, what seems to be minor injuries may develop into whiplash or serious injuries, with longstanding chronic pain. In this article, we will focus on the legal aspects surrounding motor vehicle injuries, and not on the medical treatment of the injury. A Houston personal injury lawyer or Houston truck accident lawyer may help give guidance or counseling.

As much as patients might wish to focus on recovery and physical rehabilitation following their spinal injury, there can also be a sizable legal component to the process, especially if the patients are seeking any kind of monetary compensation for their injuries. Unfortunately for patients, laypersons are generally very poor at negotiating their own terms, particularly when pitted against companies who may have entire legal teams of their own. For those suffering from a spinal injury seeking compensation, it then becomes a matter of course to seek an attorney for legal representation attorney / lawyer of their own in order to have a chance at recouping a settlement.

Much like providing quality information about your back pain to help your physician with making an effective diagnosis, your legal counsel / attorney will depend on you being forthcoming with information about your injury. If you have sustained permanent spinal damage ( back injury ) and / or a reduction in quality of life as a result of a spinal injury, pursuing a spinal injury claim through an attorney is one of the only legal options for seeking compensation. Your attorney will ask you very specific questions about the circumstances of your injury. Patients should take the time to remember the events that transpired as clearly as possible. When it comes to the spinal injury itself, medical consultation with a spine surgeon / neurosurgeon will serve to corroborate the patient’s evidence. Describe your back pain and range of motion as accurately as possible to your legal representative / attorney, including specific adjectives like burning, stabbing, shooting, throbbing, etc. as well as recounting any activities that you now face difficulty in performing. All of these details are crucial in determining the net impact of the spinal injury on your day-to-day life. The car or truck injury victim may need extensive medical or surgical intervention, or may need rehabilitation / chiropractic treatment ( physical therapy or chiropractor ) , and may suffer from lost wages or future earning potential.

Patients should also work with their motor vehicle insurance companies and the insurance company of the other vehicle (car or truck) to find out the specific details of their legal rights and coverage when it comes to pursuing a spinal injury claim. There are details of the law which pertain to what damages should be paid for by the individual’s motor vehicle insurance, and what should be covered by the motor vehicle insurance of the other care or truck involved in the collision. The injury may not be covered under the passengers own private health insurance. It is a good idea to ask the advice of their attorney ( personal injury attorney or truck accident lawyer ), before patients discuss too much, as there is a legal aspect to the case, which involves certain protocol and procedure with which the motor vehicle accident injury victim may not be familiar.

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What is Disc Degeneration in the Context of the Spine?…/what-is-disc-degeneration-in-the-…/

Degenerative disc disease (disc degeneration) has proven to be a frightening diagnosis for many members of the public. Our spinal discs (the shock-absorbing pads between our vertebrae) are essential for a high quality of life. They cushion the load-bearing stress on the spinal column and along with the facet joints (the joints between our vertebrae) spinal discs help allow for the spinal column’s articulation during routine motion.
Over time, however, the spinal discs naturally degenerate (degenerative disc diseease) , becoming thinner, harder, drier, and less capable of absorbing shock. This means that vertebrae in the spinal column move closer together, placing nearby spinal nerves at a higher risk for compression. Degenerated spinal discs also directly impact a back pain patient’s mobility, given that the discs act somewhat like the shocks and suspension on an automobile a person with compromised discs is going to move more slowly and have a smaller range of motion.
Problems also surface when back pain patients are diagnosed with degenerative disc disease. Patients may be frightened at the condition getting worse to the point of paralysis or greatly decreased mobility. While advanced damage in your spinal discs is indeed cause for concern, there are many steps patients can take to mediate back pain and improve their quality of life as they age. First, don’t give up simply because of your diagnosis. Disc degeneration is a natural process. Degenerative disc disease (disc degeneration) simply means your degeneration has progressed more quickly than is the norm.
Additionally, there are many steps patients can take at home to make sure they retain an acceptable range of motion and low-to-moderate pain levels. First, consider using over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to mediate back pain when it reaches acute levels. Pain medication will provide temporary relief and restore mobility by reducing inflammation (anti-inflammatory effects) along the spinal column (which, in a person with advanced degeneration of their spinal discs, will also help in relieving pressure on spinal nerves). A physical therapy or chiropractic regimen emphasizing core-strengthening exercises is also essential. Strong muscles throughout the torso and along the spinal column will relieve pressure from compromised spinal discs and help reduce the possibility for compressing spinal nerves. Patients also have the advantage of continuing these physical therapy / chiropractic exercises at home for an indefinite period of time, reducing medical costs and helping to maintain their mobility while reducing the possibility of further damage to the spinal discs themselves. Finally, physical therapy is an essential component in a healthy lifestyle that keeps weight at optimum levels, reducing the load-bearing stress on spinal discs and facet joints. Maintaining a healthy weight will further reduce the possibility of additional damage, while an unhealthy weight will increase the potential for nerve damage.
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