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Lumbar Spondylosis


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#1 Ogreofforce

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Posted 11 April 2012 - 08:46 AM

Hi all I just signed up after look endlessly on the internet figured I would give it a shot.

Last week after ~5 years of pain and random diagnosis I found out I have lumbar spondylosis. Basically the wings on my spine at L5 and L4 are broken off and have been for years. To the point where they rounded off and wont re heal as per the Non-VA non-Military doctor. Both him and my current chiropractor told me I will never be able to run again with out causing myself pain ( which I was already having issues with for years) and finally after 13 PT tests of being waived for runnings push up and sometimes sit ups. I now have 4 fails in the 2 year time frame and commander recommended for MEB and withdrew my LOR for it after I submitted the years of documented ongoing medical issues with my back. So now I know I shouldn't run and eventually I will get lumbar spondylostheis ( spelling) which is where my vertabre slowly move forward and cause way more pain then I currently have ( 5-7 / 10) So my biggest question is if anyone has this and how much disability they got for it. Currently I have these issues I know of medically:

Right should surgery with loss of Rand of motion
Right foot surgery with random pains ( this aparently might also be from my back)
Lumbar spondylosis

Also as of note The specialist off base Strongly discouraged me from getting the spine fusion of my 3 lower vertabre as he said I would get no current pain relief and my flexability is over all pretty good for having this issue untreated for so many years.

I plan to prepare for getting booted and want to get as much as I can being I literally broke my back for the military and so far they treated me like crap for it... Wish I didn't have to get out but seems this is whats happening. Thanks for any info you guys might be able to offer - Jeremy

#2 Pete53

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Posted 11 April 2012 - 09:44 AM

Welcome to Hadit

#3 john999

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Posted 11 April 2012 - 10:08 AM

I bet if you went to ten more orthopedists you could get ten more DX'es. However, your back hurts now and you probably don't want to aggravate it. I don't know how much you will get for it, but have you been to a pain clinic or seen a psychiatrist about chronic pain and depression.

#4 UsmcSGTVet

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Posted 11 April 2012 - 10:14 AM

Welcome

The most important thing you can do at this point is start preparing for the worse and hope for the best. Make sure you have copies of everything in your medical record because once you get out it takes to much time to request copies. If I were you I would start looking for a Veteran service officer and explain your situation to them. They will be more than happy to guide you through the process and better explain all the benefits you will be entitled to. You will also find very good people here to help try and answer your questions. I was surprised on how big of a support group is out there for us and alot of them have had similar experiences. Your not alone.

Just remember no one will care about your claim as much as you do. Try to keep the frustration to a minimum. It seems to always work out in the end.


PTSD- 50%
Right shoulder dislocations- 20%
L4-L5, L5-S1 - Buldging disks- 10%
Neurologic involvement right lower extremity- 10%
Hiatel hernia- 10%

70% Total

Edited by UsmcSGTVet, 11 April 2012 - 10:15 AM.


#5 Teac

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Posted 11 April 2012 - 11:39 AM

Welcome to Hadit,

I have had back issues for years and I have never heard of the term wings, so I look it up and the term is sometimes used to describe bone spurs, in your case bones sticking out, that from a side xray look like wings.

To answer you question, Lumbar spondylosis.. is nothing more than osteoarthritis or bone spurs usually resulting from aging or injury. It is rated under code 5003 Arthritis, degenerative (hypertrophic or osteoarthritis):

Degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.).

When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 pct is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion.

In the absence of limitation of motion, rate as below:
With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations ............................................................................................................................... 20
With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint..................................................................................................................................................... 10
Note (1): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion. Note (2): The 20 pct and 10 pct ratings based on X-ray findings, above, will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive.


The other issues you have would not be rated much higher depending on the loss of range of motion.

Edited by Teac, 11 April 2012 - 11:44 AM.


#6 71M10

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Posted 11 April 2012 - 02:44 PM

I wonder if Ogreofforce means facets, when he said wings. I havent heard of them breaking off, but in my case I have so much spuring it has locked them up (some total - some partial).

As Teac's post indicates without significant loss of motion the rating is minimal (especially when compared to the pain).

If you have documented bedrest and the test results support it a rating under IVDS could be more beneficial.

Have the doctors you have worked with ruled out any Fibromyalgia or other pain condition on top of the back injury(they would need to be pushed to look for this).

Most importantly do you have any leg pain or numbness in relation to your back and is it documented?

Best regards,

#7 jbasser

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Posted 11 April 2012 - 08:55 PM

Spondylosis will get you rated as Traumatic arthritis with range of motion being a factor.
If you have neurological issues then they are to be rated separately.

IVDS will be rated not for spondylosis but for invertabral disk syndrome.

Your better off not having IVDS rating.

The radiculopathy will be your bread and butter.

Basser

#8 cooter

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Posted 11 April 2012 - 10:56 PM

John have you ever heard of anyone being SC for radiculopathy without showing positive on shock test. Forgot the name of it.


Coot

#9 Teac

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Posted 11 April 2012 - 11:26 PM

John have you ever heard of anyone being SC for radiculopathy without showing positive on shock test. Forgot the name of it.


Coot


Shock test....? how about "nerve conductive studies" test.

#10 cooter

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Posted 12 April 2012 - 01:31 AM

Yes that's the name. Thanks Teac


Coot

#11 jbasser

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Posted 12 April 2012 - 06:21 AM

The shock test or NSC/.NCV measures the velocity a signal travels through a nerve.
There is another test that used in conjunction called an EMG.
This test consists of needled placed into the muscles to measure the electrical impulses of muscles at rest and during contraction.
I have not seen anyone get radiculopathy w/o a positive NCS/EMG.


j

#12 Ogreofforce

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Posted 12 April 2012 - 10:01 AM

I bet if you went to ten more orthopedists you could get ten more DX'es. However, your back hurts now and you probably don't want to aggravate it. I don't know how much you will get for it, but have you been to a pain clinic or seen a psychiatrist about chronic pain and depression.


I have not yet looked into Psychiatrist for chronic pain or depression. Since I found out my doc apointment is today not tomorrow I will mention getting this checked into.

Welcome

The most important thing you can do at this point is start preparing for the worse and hope for the best. Make sure you have copies of everything in your medical record because once you get out it takes to much time to request copies. If I were you I would start looking for a Veteran service officer and explain your situation to them. They will be more than happy to guide you through the process and better explain all the benefits you will be entitled to. You will also find very good people here to help try and answer your questions. I was surprised on how big of a support group is out there for us and alot of them have had similar experiences. Your not alone.

Just remember no one will care about your claim as much as you do. Try to keep the frustration to a minimum. It seems to always work out in the end.


PTSD- 50%
Right shoulder dislocations- 20%
L4-L5, L5-S1 - Buldging disks- 10%
Neurologic involvement right lower extremity- 10%
Hiatel hernia- 10%

70% Total


The wings I mentioned are the bones that connect to the back of the spine. He mentioned a thing called Pars Defect. If you google it it shows what I am talking about in the pictures, where from a side agle it looks like wings on each vertabre. It also shows those broken off. My L5 and L4 are both broken on both sides.

I wonder if Ogreofforce means facets, when he said wings. I havent heard of them breaking off, but in my case I have so much spuring it has locked them up (some total - some partial).

As Teac's post indicates without significant loss of motion the rating is minimal (especially when compared to the pain).

If you have documented bedrest and the test results support it a rating under IVDS could be more beneficial.

Have the doctors you have worked with ruled out any Fibromyalgia or other pain condition on top of the back injury(they would need to be pushed to look for this).

Most importantly do you have any leg pain or numbness in relation to your back and is it documented?

Best regards,


I have documented left foot numbness and right foot started getting numb about 1-2 weeks ago. Also I have documented shooting pains down my left leg are random intervals. Also documented I have random ( few times weekly) loss of leg strength and almost falling. Don't know if that will help my case but I a trying to get anythign associated with this documented. I have back pain documented for around 4-5 years back.

The shock test or NSC/.NCV measures the velocity a signal travels through a nerve.
There is another test that used in conjunction called an EMG.
This test consists of needled placed into the muscles to measure the electrical impulses of muscles at rest and during contraction.
I have not seen anyone get radiculopathy w/o a positive NCS/EMG.


What is radiculopathy? sciatica is what I found with it on google. I have never had a NCS/EMG test done. Should I ask for this?

Thanks for the responses I am working still and doing my job as much as I can so it is hard for me to respond during the day much. -Jeremy

#13 jbasser

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Posted 12 April 2012 - 12:32 PM

I have not yet looked into Psychiatrist for chronic pain or depression. Since I found out my doc apointment is today not tomorrow I will mention getting this checked into.



The wings I mentioned are the bones that connect to the back of the spine. He mentioned a thing called Pars Defect. If you google it it shows what I am talking about in the pictures, where from a side agle it looks like wings on each vertabre. It also shows those broken off. My L5 and L4 are both broken on both sides.



I have documented left foot numbness and right foot started getting numb about 1-2 weeks ago. Also I have documented shooting pains down my left leg are random intervals. Also documented I have random ( few times weekly) loss of leg strength and almost falling. Don't know if that will help my case but I a trying to get anythign associated with this documented. I have back pain documented for around 4-5 years back.



What is radiculopathy? sciatica is what I found with it on google. I have never had a NCS/EMG test done. Should I ask for this?

Thanks for the responses I am working still and doing my job as much as I can so it is hard for me to respond during the day much. -Jeremy


Yes you should. pain traveling up down to your leg is called sciatica which is a form or radiculopathy.

J

#14 ketchup56

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Posted 12 April 2012 - 03:23 PM

Are you positive that your diagnosis is indeed spondylosis or spondylolysis with associated anterolisthesis which in turn gives you a diagnosis as spondylolisthesis. Reason being is that if diagnosis is spondylosis this is just simple arthritis whether degenerative or osteoarthritis, where in spondylolysis is a congential defect and will never be service connected by va unless you can actually show by medical evidence that it was superimposed on during service thereby causing the spondylolisthesis which in return will automatically get you service connected. You must be sure of the correct diagnosis's, because if you in fact have spondylolysis, va will just deny as being a congential defect which as already stated is not service connectable. Please make sure of this to maybe save you some time with va as i myself have already been down this path with va .If you have any radiculopathy you could maybe also claim radiculopathy as secondary to spondylosis,spondylolisthesis and facet disease. If all this is recorded as bilateral indeed claim the bilateral as previously mentioned the neuro part of this will be your ticket as far as a decent rating.

#15 john999

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Posted 12 April 2012 - 03:28 PM

I have the kind of back pain that has also been called lumbar spondlyosis. I have pain particularly in the morning and after sitting for a while. My back is very stiff and hurts most when I bend forward at the waist like for washing dishes. Long car trips are out. Hotel beds are torture usually. It feels like my whole body from the middle of my spine to my toes is get stiffer and everything hurts. Even my hips hurt and my feet, knees and thighs hurt and feel stiff. There are so many kinds of back pain and all I know is that surger often does not help at all with pain.

John

#16 Ogreofforce

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Posted 13 April 2012 - 08:51 AM

Are you positive that your diagnosis is indeed spondylosis or spondylolysis with associated anterolisthesis which in turn gives you a diagnosis as spondylolisthesis. Reason being is that if diagnosis is spondylosis this is just simple arthritis whether degenerative or osteoarthritis, where in spondylolysis is a congential defect and will never be service connected by va unless you can actually show by medical evidence that it was superimposed on during service thereby causing the spondylolisthesis which in return will automatically get you service connected. You must be sure of the correct diagnosis's, because if you in fact have spondylolysis, va will just deny as being a congential defect which as already stated is not service connectable. Please make sure of this to maybe save you some time with va as i myself have already been down this path with va .If you have any radiculopathy you could maybe also claim radiculopathy as secondary to spondylosis,spondylolisthesis and facet disease. If all this is recorded as bilateral indeed claim the bilateral as previously mentioned the neuro part of this will be your ticket as far as a decent rating.


I am pretty sure of the diagnosis. oddly enough the chiropractor put it in his notes about 2 years ago and no one took the few moments to look. Now a Ortho spine specialist takes a look and explains it all to me. Says it is typically due to alot of stress on the back from exercise/sports OR from age. Being I am 29 I am pretty sure it is not from age and the specialist agreed. So my back was broken by his best judgement on the amount of wear on the bones about 5 years ago. I mentioned to my doc yesterday about getting tested for radiculopathy and she pretty much blew me off. but then seemed sincere about trying to help me after I mentioned I would like to see the psychiatrist (sp?) about the chronic pain and possible related depression.... So Today I will start looking for a VSO and get info from them. Thanks for the info so far it is helping me.

I have the kind of back pain that has also been called lumbar spondlyosis. I have pain particularly in the morning and after sitting for a while. My back is very stiff and hurts most when I bend forward at the waist like for washing dishes. Long car trips are out. Hotel beds are torture usually. It feels like my whole body from the middle of my spine to my toes is get stiffer and everything hurts. Even my hips hurt and my feet, knees and thighs hurt and feel stiff. There are so many kinds of back pain and all I know is that surger often does not help at all with pain.

John

Yeah I know that morning feeling... I tend to get up at 0430 just to stretch out so I can make it to work with no issues. Been doing that for about 2 years and it has been doing me good. As far as long trips go I don't take many however I have a jeep and do go out on it from time to time. This problem has reduced the number of days I can camp not to mention the hours I am able to go out and have any amount of fun in my jeep. Oh yeah you can also forget paintall, I haven't been able to play that for years either.

#17 donna68

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Posted 13 April 2012 - 09:15 PM

If you are MEB'd out, try to get permanent disability assigned rather than a temporary. Any symptoms you have in any part of your body, get it documented or go to sick call for it. Anything as minimal as it may seem, like ringing in your ears, ear aches, neck pain, upset stomach, heartburn (which pain pills can cause), hip pain, knee pain, depressed mood......

Your joint ratings will be evaluated based on pain with range of motion. The more decreased it is the higher the rating. When you have your VA exam, you want to present ato the examiner at your worst , honestly, but your worst case scenerio. So if jogging or exercise makes you feel more pain and decreases your range of motion, jog or work out the day before the exam so you are at your true worst. If you take pain pills and can miss a day, dont take your pain pills the day of the exam....

Yes, a veteran can get rated for radiculopathy, neuralgia, neuritis, numbness or tingling ..without a positive EMG, based on mild 10%, moderate 20%...symptoms. The new DBQ's/VAE's for neurological conditions list each nerve and allow for the examiner to choose the affected nerve like sciatic...and then theymust chose, one of the above.

Yes, the VA can service connect a spine condition even if its congenital, based on "presumption of soundness". Especially if the entry exam doesnt show the condition, and if a doctor will put in writing your condition was aggravated by service, you can get service connecteion. Ive seen veterans service connected for the congenital versions of spondylisis, scoliosis, ADHD, ADD......


The Spine

Rating

General Rating Formula for Diseases and Injuries of the Spine


(For diagnostic codes 5235 to 5243 unless 5243 is evaluated under the Formula for Rating
Intervertebral Disc Syndrome Based on Incapacitating Episodes):

With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease

Unfavorable ankylosis of the entire spine................................................................... 100

Unfavorable ankylosis of the entire thoracolumbar spine............................................... 50

Unfavorable ankylosis of the entire cervical spine; or, forward flexion
of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of
the entire thoracolumbar spine................................................................................ 40

Forward flexion of the cervical spine 15 degrees or less; or, favorable
ankylosis of the entire cervical spine........................................................................ 30

Forward flexion of the thoracolumbar spine greater than 30 degrees but not
greater than 60 degrees; or, forward flexion of the cervical spine greater
than 15 degrees but not greater than 30 degrees; or, the combined range of
motion of the thoracolumbar spine not greater than 120 degrees; or, the
combined range of motion of the cervical spine not greater than 170 degrees;
or, muscle spasm or guarding severe enough to result in an abnormal gait
or abnormal spinal contour such as scoliosis, reversed lordosis, or
abnormal kyphosis................................................................................................. 20

Forward flexion of the thoracolumbar spine greater than 60 degrees but not
greater than 85 degrees; or, forward flexion of the cervical spine greater than
30 degrees but not greater than 40 degrees; or, combined range of motion of
the thoracolumbar spine greater than 120 degrees but not greater than 235
degrees; or, combined range of motion of the cervical spine greater than
170 degrees but not greater than 335 degrees; or, muscle spasm, guarding,
or localized tenderness not resulting in abnormal gait or abnormal spinal
contour; or, vertebral body fracture with loss of 50 percent or more of the
height..................................................................................................................... 10

Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.

Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion.

Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner’s assessment that the range of motion is normal for that individual will be accepted.

Note (4): Round each range of motion measurement to the nearest five degrees.

Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.

Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability.

#18 Ogreofforce

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Posted 16 April 2012 - 07:39 AM

If you are MEB'd out, try to get permanent disability assigned rather than a temporary. Any symptoms you have in any part of your body, get it documented or go to sick call for it. Anything as minimal as it may seem, like ringing in your ears, ear aches, neck pain, upset stomach, heartburn (which pain pills can cause), hip pain, knee pain, depressed mood...... Your joint ratings will be evaluated based on pain with range of motion. The more decreased it is the higher the rating. When you have your VA exam, you want to present ato the examiner at your worst , honestly, but your worst case scenerio. So if jogging or exercise makes you feel more pain and decreases your range of motion, jog or work out the day before the exam so you are at your true worst. If you take pain pills and can miss a day, dont take your pain pills the day of the exam.... Yes, a veteran can get rated for radiculopathy, neuralgia, neuritis, numbness or tingling ..without a positive EMG, based on mild 10%, moderate 20%...symptoms. The new DBQ's/VAE's for neurological conditions list each nerve and allow for the examiner to choose the affected nerve like sciatic...and then theymust chose, one of the above. Yes, the VA can service connect a spine condition even if its congenital, based on "presumption of soundness". Especially if the entry exam doesnt show the condition, and if a doctor will put in writing your condition was aggravated by service, you can get service connecteion. Ive seen veterans service connected for the congenital versions of spondylisis, scoliosis, ADHD, ADD......


Lots to read and look up. I am pretty sureI can not get ADHD as I had that as a kid and such they will say you already had it. I have been looking this stuff up you put in your post and trying to figure out from my medical records what I can claim possibly. Been trying to get a VSO but have been really busy at work and home. Will update you guys when I find out more from them as well.