Lumbar Fusion - One Level

[81150 CAFB]

I just want to see if I understand the regs properly - please correct me if I am reading it wrong. I had a diskectomy just over three months ago and never got better. Recent post-op Myleogram showed same disk reruptured again on both sides so I had a fusion at the L4-L5 level. If I am reading the regs correctly... the compensation is still based on range of motion (pain of motion) and not ankylosis since the entire lumbar section is not fused. Is this correct? Doesn't the fusion automatically limit ROM (two weeks post-op- definately does)? Any back fusion people on the site- how are you doing long- term?

Thanks for any replies.

81150 CAFB

[81150 CAFB]

J- thanks for the link... my main issue with the regs is that rating is the same for diskectomy(ivds) versus fusion. In that they are both just rated on ROM, when the fusion is such a serious surgery. I guess the fusion will limit your ROM more then a discectomy. I have't really tried to do anything yet since I am just over two weeks post-op.

I really had no choice in the fusion. One diskectomy in the Air Force in 1989, then one in August of 2009 with no relief and a myleogram showing that both sides had ruptured post-op. Neuro wanted to first do a double diskectomy but talked himself out of it and had another neuro in their group look at my scans and recommened a fusion as the best longterm solution. The surgery wasn't to bad...in hospital 3 days and only did two cuts in the back on either side of L4-L5. No cut in front. Recovery seems to be going ok...still some pains in butt and some calf spasms etc... I feel better- just fragile. Only thing they told me to do so far is to walk as much as I can. However, during my walks (some of you back guys can tell me if this is normal) and after, my hips are in a lot of pain.

Thanks to all!

FYI - I gave thev VA a informal request in September and I am still gathering all of my records on my own and will file when recieved. I want to make it as simple as possible and spell everything out for them to include codes (traumatic arthritis etc...)

81150

[81150 CAFB]

J - looking at the regs I am really looking at 20% with a forward flex limited in the range of 30-60% and any secondry from nerve issues. 40% for 0-30 degrees doesn't seem likely... we shall see how the recovery goes. Any one here rated at 40% for fusion of one level only?

81150

[willie 74]

I am recieving forty for one level disk fusion. Like everyone is saying, you take your chances and not every fusion works. Based off of range of motion etc. Your nerves will be effected regardless, with me it is my bladder and legs. I am 35 and walk like someone in their 70's no offense to my elders. I am now in chronic pain and have tried just about every type of pain relief. I dont want to send negative things about a fusion, i believe most do help people. But in my case it did not work. So now I am trying to concentrate on what happiness I have left and seeking help for my depression.

[81150 CAFB]

Started PT last week and had them test ROM with gnominoter(?). The flex was 20 deg and the ext was about 10 deg. Lateral side bend were 19 and 20 respectively. The measurements were pretty much the same before PT and after. Still in a lot of pain in my lower back and left butt. The doc is still concerned about my severe sciatic pain in my left butt. He said it may be bruised or permanent. It is very difficult for me to sit for any length of time. Doctor wanted me to try PT to see if it would help and after a couple of weeks to try a nerve drug called lyrcia. I don't think I even want to try the nerve med since most of the interactions relate to the meds I am taking for anexity and flexeril and soon depression.

I just wish they could figure out why I still have the severe butt pain. I have no other leg pain just some hard touch loss (can feel light touch - but you can poke my calf really hard with a toothpick and it doesn't hurt-just feel pressure) tingles, slight numbness etc..

Willie- what kind of bladder issues are you having. Basically since my fusion I have had trouble maintaining stream with a lot of stop and go. At first I thought it was from cath and then just chalked it up to my vicodine. Maybe it is an nerve issue? Need to bring this up to my doc.

Thanks

81150

[willie 74]

Started PT last week and had them test ROM with gnominoter(?). The flex was 20 deg and the ext was about 10 deg. Lateral side bend were 19 and 20 respectively. The measurements were pretty much the same before PT and after. Still in a lot of pain in my lower back and left butt. The doc is still concerned about my severe sciatic pain in my left butt. He said it may be bruised or permanent. It is very difficult for me to sit for any length of time. Doctor wanted me to try PT to see if it would help and after a couple of weeks to try a nerve drug called lyrcia. I don't think I even want to try the nerve med since most of the interactions relate to the meds I am taking for anexity and flexeril and soon depression.

I just wish they could figure out why I still have the severe butt pain. I have no other leg pain just some hard touch loss (can feel light touch - but you can poke my calf really hard with a toothpick and it doesn't hurt-just feel pressure) tingles, slight numbness etc..

Willie- what kind of bladder issues are you having. Basically since my fusion I have had trouble maintaining stream with a lot of stop and go. At first I thought it was from cath and then just chalked it up to my vicodine. Maybe it is an nerve issue? Need to bring this up to my doc.

I would bring it up for sure. My bladder did not work until two weeks after the sugery. I was sent home wiith a catheder. I have an appointment next week so I will see what they say about everything. I also have issues holding a stream and starting one. I have tried just about all the meds for it with no success. There are so many nerves around that area, the doc believes my bladder issue was a side effect from the sugerysince i never had issues with it before. I am now putting in for the depression claim, seems to be almost worse than my physical issues. Will let you know what the specialist says. Best of luck... Pete

Thanks

81150

[willie 74]

I had the meeting with the specialist, they basically said my bladder problems where due to my back and the more pain I have the more the bladder will have issues.