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Disc Herniation - Hero
The Spinal KineticsMay 6, 2024 3:36:07 PM5 min read

Understanding the Impact of Spinal Support Ligament Injuries on Disc Health


In the realm of spinal injuries, for far too long, the spinal support ligament has been a victim of neglect.  Modern research tells us the following about these non-disc spinal support ligaments by stating the following: "The ligament component of spinal stability is related to the support, health, and proper function of these tissues and often overlooked as a major, if not the major, source of back pain and ultimate degeneration.  The case can be made the excess use of even complete dependence on the MRI has focused too much attention on the intervertebral disc and the vertebrae themselves to the exclusion of the ligaments and the facet joint capsules".   We at Spinal Kinetics could not agree more with this statement.

The Anatomy of the Spine: A SIMPLE Structure

The spine consists of bone and connective tissue. This basic understanding simplifies spinal injury assessments, as there are only two types of injuries to consider: bone injuries or connective tissue injuries, or a combination of both. Fractures are typically detected through X-rays or CT scans, but we won't focus on them here.

Instead, we'll explore chronic pain-inducing injuries to the spinal support ligaments and their impact on the discs. It's important to note that there are 220 ligaments holding the spine together, with only 23 of them being discs; the rest are spinal support ligaments, also known as non-disc spinal ligaments. These ligament injuries, according to Medscape, are responsible for the majority of patients' symptoms, surpassing disc-related issues, and could be considered the primary injury.

 EARLY MRI: Leads to Doubling Patient Disability Rates

A quick Google search on "Does early MRI increase patient disability rates?" reveals that indeed it does, along with significantly escalating associated costs. Despite the excessive focus on the disc, this approach has only led to increased expenses across the board. Present-day insurers and personal injury attorneys worsen the situation with their narrow-minded belief that the disc is the sole culprit, disregarding extensive research and publications suggesting otherwise.


The issue lies in exclusively concentrating on the disc without addressing the primary injury, which is damage to the spinal support ligaments, resulting in spinal instability. This instability is responsible for the majority of symptoms experienced by the patient, as confirmed by Medscape. It is also can be the primary source of the majority of symptoms in mild traumatic brain injuries (MTBI) cases. Forgetting everything that is associated with the spinal support ligament injury and relying solely on early MRI scans can misdirect patients towards inappropriate care paths, ultimately diminishing outcomes and often substantially inflating costs.

Assessing Disc Injuries Buried By Other Spinal Ligaments

In the illustration, discs reside deep within the spine, ensconced by red ligaments providing crucial support. Damage to these ligaments, visible on radiological scans, often signals excessive movement and leads to spinal instability, potentially permanent. These injuries, now detectable through imaging, are frequently the main source of symptoms, as reported by Medscape. It's vital to acknowledge that harm to these spinal ligaments can occur severely, even in the absence of apparent disc damage. Regrettably, prevalent beliefs among insurers and personal injury attorneys often misinterpret negative MRI results as an absence of injury, despite the reality being quite different. In cases of auto, work, or sports-related spinal injuries, there isn't a precise impact solely on the disc. That analogy would be akin to assaulting a person's leg with a baseball bat and merely noting a broken bone, ignoring the surrounding tissue damage such as split open skin and muscle damage caused by the force of the impact. Unfortunately, this prevailing notion and practice in today's spinal injury realm presume that disc damage can occur in trauma without harming the surrounding ligaments. When a disc herniation is the sole finding on MRI, it likely indicates a pre-existing disc condition rather than trauma-induced damage.220 Ligaments

Excessive Motion: Indicative of Spinal Ligament Damage

An essential criterion for identifying spinal ligament injuries lies in assessing the degree of excessive motion they induce. Typically, this evaluation requires advanced testing to gauge the severity of the injury based on specific degrees of motion. It's imperative that such testing be conducted whenever possible, by independent medical radiology services employing FDA Cleared Technology to ensure unbiased results. This eliminates the potential for provider bias, as some may have a vested interest in overstating injury severity to justify additional care, whether necessary or not. Providers who conduct and bill for such testing themselves may employ questionable technologies that lack FDA clearance.  They may also intentionally or unintentionally manipulate the studies to show greater injury than there actually is, potentially inflating the perceived severity of injuries. 

The spinal injury market urgently needs to move away from these practices.

At Spinal Kinetics, we address these concerns for providers and insurers and revolutionize the procedure by integrating advanced FDA Cleared AI. This AI autonomously detects these injuries, significantly enhancing the accuracy of our radiologists' assessments. We firmly believe that all spinal injuries should undergo excessive motion testing, and with the adoption of this technology, testing costs will decrease over time, all while AI improves in its ability to accurately produce the studies as it learns with each new study. It's important to note that this technology doesn't replace radiologists but enhances their efficiency.

Interplay Between Disc and Ligament Injuries

While it's not uncommon to encounter cases where surgical levels of spinal support ligament damage occur without any disc herniations, it's also feasible for spinal support ligament injuries to manifest most, if not all, of the clinical symptoms typically associated with Mild Traumatic Brain Injury (MTBI) in advanced certification programs, even in the absence of disc herniations or with disc herniations not correlating with the symptoms.

When a patient presents with a disc herniation on MRI, the primary inquiry should revolve around the condition of the supporting spinal ligaments. Understanding the extent of damage to the surrounding tissue is crucial. If these ligaments exhibit moderate to severe damage, the case becomes significantly more complex.

The Need for Standardized Spinal Injury Assessments

The spine comprises only two tissues and can be injured in three primary ways: through fractures, disc herniations, excessive motion, or a combination of these factors. Regardless of the type of doctor a spinal injury patient consults, the evaluation should remain consistent, as all spinal injuries share the same fundamental characteristics. The only variable lies in the individual condition of each patient who receives these injuries in an accident.

At Spinal Kinetics we make standardized spinal injury evaluations a reality. 


A deep understanding of spinal injuries, particularly the relationship between ligaments and discs, is crucial for effective treatment and rehabilitation. Recognizing the interdependence of these spinal components and employing state-of-the-art diagnostic tools are key to achieving optimal diagnostics, leading to better treatment innovations and better patient outcomes.

In conclusion, maintaining spinal health requires understanding the intricate balance between its various components. A comprehensive approach to spinal injuries, focusing on both ligaments and discs, is essential for effective management and treatment.