Ivds/ddd And Spinal Fusion? Post-op

[Quint7]

Hi all, I'm almost 3 weeks post-op for a L4-5 spinal fusion (feel better than in 10 years!) and I am about 5 weeks post DRO hearing seeking SC for IVDS/DDD.

My question is, if I ever get another exam (as the DRO hearing officer said she wanted me to have), should I make a point of the fact that although I NOW have a spinal fusion at one level (L4-5), I STILL have IVDS/DDD at the next level down (L5-S1) and therefore should be service connected for BOTH. Not compensated, but SC. I don't think that now I will have any ratable issues from the IVDS/DDD in the short term other than surgery induced limited range of motion, and I'm pretty sure that a spinal fusion is an automatic 40%.

My issue is that the effects of IVDS/DDD don't go away, the fusion will put stress on the next level higher and therefore I want the VA to list me as SC for BOTH IVDS/DDD and the Fusion that resulted from it.

Any thoughts? I know seeking comp. for both at this time would be pyramiding..... or at least I think it would.

Thanks!

[Quint7]

jbasser, I was wondering that myself. Could they possibly expect someone to have all 5 lumbar vertebre to be fused? Or any complete spinal section? I mean, I'm not a doc (I am an EMT... LOL), but how many people could possibly ever have that done? I mean.... to have more than 3 sections fused would mean that a person is basically paralized I would think.

Again, I tried actually talking to the DRO officer but she just sat there saying it will all be reviewed and decided according to the regulations.

As for the surgery, I have (had?) 2 discs almost totally gone. No fractures. L4-5 were grinding on each other and L5-S1 had no visable (on MRI) problems other than the disc being gone. The Nuerosurgeon told me that the L5-S1 was about what he would expect from a guy my build who had led a life like mine. He told me that barring any unforseen issues, there was no point fusing the L5-S1 as the chance for complications went up by about 70% with a 2 level fusion. So far he was right. I haven't felt this good in forever. No pain when I sneeze, Digestive problems have almost gone away. No "swayback" when I get up in the morning.

Other than laser eye surgery, so far this is the best decision I've ever made. I would say, see a Nuerosurgeon, not an Orthopedic. I saw an orthopedic doc for 7-8 months who immediately wanted to fuse all 3 levels going through my back and stomach. My Nuero bsaicaly said "he does knees and hips, I'm a brain surgeon. Forget you ever met that quack".

[rentalguy1]

That's true, John, it does say the "entire" tc spine. Thanks for pointing that out. I would still say a 40% rating would be safe bet for Quint, though, because the loss of ROM will be significant. I am at 15* forward flexion without a fusion. All of my facet joints have grown together and don't allow for flexion any more.

[Quint7]

I just pulled up the exam sheet and it doesn't mention "complete".

v. Describe any postural abnormalities, fixed deformity (ankylosis), or abnormality of musculature of back. In the situation where there is unfavorable ankylosis of the thoracolumbar spine, indicate whether there is: difficulty walking because of a limited line of vision; restricted opening of the mouth (with limited ability to chew); breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea; dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root involvement.

From:

http://www.vba.va.gov/bln/21/Benefits/exams/disexm53.htm

Man the VA knows how to word stuff to make it so that they can apply the regs however they feel at that time.

[rentalguy1]

The exam doesn't say it, but the rating criteria does.

[Quint7]

No, I know that Rental. I was just thinking that they would want the examiner to document that it was "complete". How would the rater know? I mean, we all know that the C&P exam results sheet is what they look at more than any other thing in the C-file... lazy bastards. LOL

[rentalguy1]

this just represents the required disconnect between the VHA and the VBA.