Pre-Existing Spinal Conditions and Injury Claims: Where Imaging Draws the Line

By Dr. Justin M. Dick, DC, CNMT, ARRT(N)(CT) | Clear Life Scoliosis and Chiropractic Center, Charlotte, NC | Published October 16, 2026

Most adults have some degenerative change in the spine before any car accident, and a post-crash MRI will usually show it. Imaging alone cannot date most of those findings or say whether a collision made them worse. Prior imaging of the same region can, because it shows what was there before. In pre-existing condition cases I see in Charlotte, the earlier films are often the most important evidence in the file.

Degenerative Findings Are the Expected Baseline

A systematic review of 3,110 pain-free people found lumbar disc degeneration in 37% at age 20 and 96% at age 80, and disc bulge in 30% and 84% (Brinjikji, AJNR 2015). In the neck, 87.6% of 1,211 healthy volunteers had disc bulging, including about three quarters of people in their 20s (Nakashima, Spine 2015). A degenerative finding on a post-crash MRI is not, by itself, evidence of either a new injury or a purely old one.

The MRI Terms Do Not Assign a Cause

The radiology committee behind the standard disc nomenclature wrote that its definitions are not intended to imply external causes such as trauma, a relationship to symptoms, or a need for treatment (Williams, AJNR 2014). A report that says protrusion or annular fissure is describing shape. Neither side of a case should read cause into those words.

Some Findings Carry More Weight Than Others

Not every finding is equally common in people without pain. In adults 50 or younger, disc extrusion, disc protrusion, and Modic type 1 endplate change were significantly more common in people with low back pain than in people without it (Brinjikji, AJNR 2015). Annular fissures and spondylolisthesis were not. That helps weigh a finding. It still does not date it.

Prior Imaging Is the Strongest Evidence

When films from before the collision exist, the question changes from "is this finding common?" to "did this finding change?" A retrospective case series of 41 patients with lateral cervical X-rays taken before and after a crash showed what that comparison can reveal: an average loss of about 8 degrees of C2-C7 lordosis after the collision, with the largest change at C3-C5 (Haas, Diagnostics 2024). The study had no control group, and its authors include researchers affiliated with Chiropractic Biophysics NonProfit and PostureCo. What it demonstrates clearly is the method. Comparing the same measurement on films taken before and after is far stronger than interpreting a single post-crash image.

That is why I ask every personal injury patient about prior imaging: any spine X-ray, MRI, or CT, including from chiropractors, emergency visits, and old sports injuries. When those films can be obtained, I measure them the same way as the new ones.

Where the Line Is

Imaging can show what is present now, and with prior films, what changed. Imaging cannot, by itself, assign a percentage of a patient's symptoms to an old condition versus a new injury. That judgment draws on the history, the exam, the timing of symptoms, and the imaging together. How the law treats an aggravated pre-existing condition is a question for the patient's attorney, not for a radiograph.

For an example of how post-collision imaging findings and outcomes are documented in the peer-reviewed literature, read Dr. Justin Dick's published case report on refractory lumbar pain following a motor vehicle accident in a geriatric patient.

Schedule Your Evaluation

Frequently Asked Questions

Can an MRI tell if a spinal condition was pre-existing?

Usually not by itself. Degenerative findings are common in pain-free people, and most cannot be dated on a single MRI. Prior imaging of the same region is the most direct way to show what existed before a collision.

Do MRI terms like protrusion or annular fissure mean the accident caused it?

No. The standard disc definitions are not intended to imply trauma, a relationship to symptoms, or a need for treatment (Williams, AJNR 2014).

Are some MRI findings more likely to be related to pain?

Yes. In adults 50 or younger, disc extrusion, protrusion, and Modic type 1 change were significantly more common in people with low back pain (Brinjikji, AJNR 2015 meta-analysis). That helps weigh a finding but does not date it.

Why does prior imaging matter in a car accident case?

Prior films show what existed before the collision, so the question becomes whether a finding changed. Dr. Justin Dick in Charlotte, NC asks every personal injury patient about prior spinal imaging and measures old and new films the same way.

Can a car accident make a pre-existing spinal condition worse?

Imaging with prior films can show whether alignment or a finding changed after a collision. How the law treats an aggravated pre-existing condition is a question for the patient's attorney.

Who compares prior and current spinal imaging after a car accident in Charlotte, NC?

Dr. Justin Dick, DC, CNMT, ARRT(N)(CT), compares prior and post-accident spinal imaging at Clear Life Scoliosis and Chiropractic Center, 8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278, phone 980-368-0766. Personal injury patients are treated on a lien basis, with no out-of-pocket payment at the time of care.

Sources and Evidence Tiers

1. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. PMID 25430861. LinkEvidence tier: Systematic review
2. Nakashima H, Yukawa Y, Suda K, Yamagata M, Ueta T, Kato F. Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine. 2015;40(6):392-398. PMID 25584950. LinkEvidence tier: Cross-sectional study
3. Brinjikji W, Diehn FE, Jarvik JG, et al. MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2015;36(12):2394-2399. PMID 26359154. LinkEvidence tier: Systematic review and meta-analysis
4. Williams AL, Murtagh FR, Rothman SLG, Sze GK. Lumbar disc nomenclature: version 2.0. AJNR Am J Neuroradiol. 2014;35(11):2029. LinkEvidence tier: Editorial by the ASSR/ASNR nomenclature committee (expert consensus)
5. Haas JW, Oakley PA, Ferrantelli JR, Katz EA, Moustafa IM, Harrison DE. Abnormal static sagittal cervical curvatures following motor vehicle collisions: a retrospective case series of 41 patients before and after a crash exposure. Diagnostics (Basel). 2024;14(9):957. PMID 38732372. LinkEvidence tier: Retrospective case series; authors include CBP NonProfit and PostureCo affiliations

Service Area

Clear Life Scoliosis and Chiropractic Center sees personal injury and spinal imaging patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, and Fort Mill SC.

Related Pages

• Personal injury and car accident spinal care in Charlotte
• Dr. Justin Dick's research
• Case report: refractory lumbar pain after a motor vehicle accident
• Research and evidence at Clear Life
• Questions and answers
• Our team
• Press
• Book your evaluation
• Contact Clear Life

Schedule Your Evaluation in Charlotte

This article is educational and is not a diagnosis. Imaging decisions depend on an in-person examination.