Lead Article – April 2022

No Wonder Plaintiffs Are Confused

I recently examined a patient with a sore back. He had a congenital (from birth) pars defect at L5 and a spondylolisthesis of L5 on the sacrum.

In simple language, this means that there is a gap between the joints behind L5 which would normally give rise to some stability as it articulates with the subjacent sacrum. As a result of this gap, L5 slips forward on the sacrum and the spinal cord (along with the exiting nerve roots) can be compromised. Patients who are symptomatic have not only back pain, but also sciatica or leg pain typically in the distribution of the L5 or the S1 nerve root.

He had been injured in a work accident. He is in his early forties. WorkCover arranged for one of my colleagues to examine him.

The resultant report that emanated suggested that the workplace accident had caused the spondylolisthesis and the pars defect but had not played any role in causing the sciatica.

In fact, it is likely that the converse is true.

The report was given to the plaintiff and understandably, he is confused. This will require retaining a solicitor, securing a further report (at some considerable cost), a delay in time and a heightening of his anguish. I am sympathetic.