Cervical MRI results

[Andyman73]

Hello all you Vets in Hadit land!!!

I recently had an MRI done at the behest of my PCP.  I am posting the results for youse guys to ruminate upon.  I filed a claim some time ago for pain in the neck that was secondary to back issues.  Well, that was a no go.  I didn't remember if I ever had been seen during my AD years for any neck issues.  Well, I did find a complaint of pain in my neck.  It was when I fell down the stairs during my first week of boot camp, in November 1992.  On the ER report it shows complaint of defuse pain in the neck, and other areas.  And while no injury was found during the exam, in my neck area, it was sore for a few days.  I was given 800mg Motrin for pain in other body areas, which subsiquently were granted SC after my enlistment. 

I have mentioned to my PCP, over the past 2-3 years, feeling tingling, numbness and hot flashes in my upper extremities, and shoulders.  It varies depending on the activity and position of my neck.  My neck is stiff all the time, and I am constantly cracking and stretching my neck.  If I don't it leads to headaches rather quickly.

Report: Cervical spine MRI   Clinical history: Evaluate for evidence of cervical radiculopathy   Procedure: Sagittal Ti-weighted, T2-weighted, STIR sequences, axial T2-weighted gradient echo and turbo spin echo sequences   Discussion: Comparison is made with cervical spine radiographs performed  2/27/2015.   The alignment of the vertebral bodies is normal and the heights of the vertebral bodies are maintained. The signal characteristics of the bony elements are normal. There is no evidence of an acute osseous abnormality. The spinal cord demonstrate normal morphology and normal signal characteristics.   At C2-C3 the disc spaces unremarkable. The spinal canal and the neuroforamina are patent. There is slight narrowing of the right neural foramen secondary to uncovertebral spurring.   At C3-C4 the disc space is unremarkable. The spinal canal is widely patent. The right neural foramen is mildly to moderately narrowed by uncovertebral spurring. The left neural foramen is moderately narrowed by uncovertebral spurring.   At C4-C5 there is very mild disc degeneration. The spinal canal is widely patent. The neuroforamina widely patent.   At C5-C6 there is mild disc degeneration. There is slight central disc bulge which does not cause significant spinal canal narrowing. The left neural foramen is mildly narrowed by uncovertebral hypertrophy. The right neural foramen is largely patent.   At C6-C7 there is mild disc degeneration. There is a linear focus of high signal along the left paracentral dorsal aspect of the disc which may represent a fissure of the annulus fibrosis. There is a slight central disc bulge that significant narrowing of the spinal canal and the neuroforamina bilaterally mildly narrowed secondary to uncovertebral hypertrophy   At C7-T1 the disc space appears normal. The spinal canal and neuroforamina widely patent.

The last part didn't paste, so here is the last few lines;

paraspinous soft tissue is unremarkable,  impression: Multilevel mild disc disease with mild to moderate neural foramina narrowing as detail above.  Primary diagnostic code; abnormality noted.

Thanks again to all who opine here.

Andyman

[brokensoldier244th]

Are you wondering if it is rateable? Absolutely, to varying degrees. If you look up CFR 38 you can see the exact structure they use for rating the back. 

 

Quote

Quote

THE SPINE

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.

(No. 55 8/5/15)

 

4.71a-21 §4.71a—Schedule of ratings–musculoskeletal system 4.71a-21

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

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

5239 Spondylolisthesis or segmental instability

 

5242 Degenerative arthritis of the spine (see also diagnostic code 5003)

Evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the

General Rating Formula for Diseases and Injuries of the Spine or under the Formula for

Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method

results in the higher evaluation when all disabilities are combined under §4.25.

(No. 55 8/5/15)

4.71a-22 §4.71a—Schedule of ratings–musculoskeletal system 4.71a-22

Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes

With incapacitating episodes having a total duration of at least 6 weeks during the

With incapacitating episodes having a total duration of at least 4 weeks but less than

With incapacitating episodes having a total duration of at least 2 weeks but less than

With incapacitating episodes having a total duration of at least one week but less than

past 12 months 60

6 weeks during the past 12 months 40

4 weeks during the past 12 months 20

2 weeks during the past 12 months 10

Note (1): For purposes of evaluations under diagnostic code 5243, an incapacitating

episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires

bed rest prescribed by a physician and treatment by a physician.

Note (2): If intervertebral disc syndrome is present in more than one spinal segment,

provided that the effects in each spinal segment are clearly distinct, evaluate each segment on the

basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of

the Spine, whichever method results in a higher evaluation for that segment.

 

Edited March 3, 2016 by brokensoldier244th

[Andyman73]

It really all depends if it can be linked to that fun trip down the stairs.  I know I sure do enjoy the hot flashes, which feels like sunburn or steam burns on my skin.  And I love the burning heat sensation that goes down the back of my neck through my shoulders and upper back.  Feels like hot water running down, but in the muscles, not on the skin like the other hot flashes.

[brokensoldier244th]

Were you discharged for that injury? If so, thats already your link because your MEB/PEB would have had a line of duty form for the injury. 

[TALON II FE]

Not related to claims, but from my experience you should not get surgery yet.  Extend as long as you can.  Just in case they are suggesting it to get docs their chop shop quotas.  Good luck!

[brokensoldier244th]

Chop shop quips aside, avoid surgery as long as you can in favor of conservative maintenance. Once they cut and put in a cadaver disc or fuse, your other vertebra and discs around it have to compensate for that and eventually (5-6 yrs last I read) youd be in again for another one. 

[Andyman73]

2 hours ago, brokensoldier244th said:

Were you discharged for that injury? If so, thats already your link because your MEB/PEB would have had a line of duty form for the injury. 

No sir, fulfilled the requirements of my 6 yr enlistment.  My back and knees were much more of an issue, from the same fall, and took most of my attention.  And a daily regimen of Vitamin M(motrin) kept most of the pain to a dull ache.

As for surgery, my twin brother has scar tissue on his spinal cord from the VA.  They were removing a bulging disc and nicked his cord, making the disc related symptoms permanent.  So, yeah...not too interested in that, at least not at this time.