Episode 30: What Spine Scans Can Miss After a Crash

A patient leaves the emergency room after a crash and is told the imaging looks normal. But days later, the pain is worse, movement is limited, and everyday activities have become difficult. What happens when the scan and the patient’s experience do not match? In this episode of *Crashes, Claims & Clarity*, Darrell L. Burrow speaks with Dr. Ben Burch, a double board-certified orthopedic spine surgeon at the Atlanta Spine Institute. Dr. Burch explains that emergency room imaging is designed to answer specific questions. A CT scan can provide valuable information about bones and traumatic injuries, but it may not reveal every soft-tissue injury, muscle or ligament strain, or other source of pain. A more obvious injury can also create “distracting pain,” causing a patient to overlook symptoms in another part of the body until later. The conversation also examines one of the most difficult questions following an accident: Did the crash cause a spinal condition, or did it aggravate a condition that was already present? Dr. Burch explains why imaging alone cannot always answer that question. The timing of symptoms, the patient’s history, previous medical records, physical examination, functional limitations, and response to treatment can all help provide a more complete clinical picture. Darrell and Dr. Burch also discuss how physicians determine whether conservative treatment is working, when progress has plateaued, and when surgery may become an appropriate option. Dr. Burch describes his multimodal approach to nonsurgical care, which may include physical therapy, anti-inflammatory treatment, medications directed at nerve or muscle symptoms, and carefully targeted injections. The episode then moves inside the operating room as Dr. Burch explains the difference between uniportal and biportal endoscopic spine surgery. He describes endoscopic surgery as a tool that allows surgeons to reach and treat spinal problems through narrow corridors while attempting to reduce unnecessary damage to surrounding tissue. Listeners will learn: - Why a normal CT scan does not necessarily explain persistent pain - How distracting pain can hide a secondary injury after a crash - Why degenerative changes on an MRI may have existed without symptoms - How doctors evaluate whether a crash caused or aggravated a condition - Why functional progress may be more useful than a simple pain score - How physicians recognize when conservative care has stopped producing progress - The difference between uniportal and biportal endoscopic spine surgery - Why a small incision does not mean the underlying condition was minor - What patients should ask before agreeing to a spine procedure - Why AI can assist with measurements but should not replace human clinical judgment Dr. Burch also encourages patients to seek another opinion when appropriate and to ask surgeons direct questions about alternative treatments and their experience performing a recommended procedure. ## About Dr. Ben Burch Dr. Ben Burch is a double board-certified orthopedic spine surgeon at the Atlanta Spine Institute. He specializes in nonsurgical care and advanced minimally invasive and endoscopic procedures, including both uniportal and biportal techniques. Dr. Burch treats traumatic injuries, herniated discs, spinal stenosis, degenerative conditions, and other complex spinal disorders. He also trains surgeons, contributes to spine research, and performed Georgia’s first endoscopic spinal fusion procedures. Learn more about Dr. Ben Burch and the Atlanta Spine Institute: https://atlantaspineinstitute.com/our-practice/dr-ben-burch/ Listen to *Crashes, Claims & Clarity*: https://podcasts.apple.com/us/podcast/crashes-claims-clarity/id1824256144 If you or someone you love has been injured in a Georgia accident, learn more about Darrell Burrow and Burrow & Associates at LegalAtlanta.com.