Lower Back And Neck Problems

[kris]

First of all thank you to this board. I ask some questions before and I feel they were probley pretty stupid questions by some of my responses. I will try to listen better.

First of all I am at 50% for Depression and Panic attacks.

When I was in the military I was seen quite abit for lower back pain. I had never had back pain before the military. After about a year and a half of military service the Doctors finally took Xrays not a MRI and here is the xray report.

LUMBAR SPINE: The superior endplates of L1 2 and 3 have depressions consistent with Schmorl's nodes. This is the result of old juvenile epiphysitis. In the frontal view there is a slight scoliosis toward the right. L1 2 and 3 appear to be slight diminished on their left side and again I wonder as to the relationship of the previous juvenile epiphysititis. This does not appear to be acute. The remaining vertebral bodies are of normal heights as are the intervertebral spaces.

CONCLUSION: Chronic abnormalities of L1 2 and 3 have been described probably on the basis of juvenile epiphysitis.

And crossed out with a line is except schmorl's nodes upper lumbar area.

I have had 3 back surg since I have been out of the military and not in one MRI report does it say I had Juvenile epiphysitis.

I do not see in my SMRs where I ever went ito the doctors for a injury, I just kept going to see the doctors for LBP when I was in the service. And sometimes was put on light duty or no duty for 3 or 4 days here and there.

Also I hurt my neck and head while in service with a pretty good fall. I am unable to obtain employment because of my neck right now because it is affecting both my arms, neck and shoulders. I am devastated (sp) to say the least with no income except my SC income.

I am not sure if I am able to file a claim for either one of these conditions.

I hope I explained myself right.

Thank you for your help and advise. Kris

[Pete53]

kris no question is stupid. What is dumb is not to ask questions.

I think you should file a claim for your back. You have problems in your Service Records and it has been a problem since you got out and also surgeries. I think you have a claim that should not be that hard to win.

Good Luck

[Testvet]

I will never forget that Drill Sergeant in 1973 telling me the only stupid question there is, is the one you don't ask. Many of us forget stuff, have a CRS moment etc, the only one who knows everything is my wife and she don't post here lol......

[kris]

Thank you for talking to me. I do have copies of my SMR and I have been seeing a Doctor at the VA for 2 years but I have never showed him my records or even talked about it. All he knows is that I have had 3 back surgs. And I am sure thats just by my scars I have never even showed him those records. He gives me pain meds. That is how I have made it through the last 2 years on my jobs.

Thank you again, I will get a copy of all my surgs and any other records, and OK I will make copies.

Thank you again

[sixthscents]

OK, I asked myself first what is this node and disease... a search found this ... finally

In 1921, Scheuermann described a disorder that led to lower thoracic kyphosis and on the basis of irregularities involving the rims of the bodies, he concluded that the pathology occurred in the region of the growth areas between the vertebral bodies and the ring-like epiphyses. The predominant involvement of the epiphysis of the vertebral rim was initially interpreted as osteonecrosis, however, considerable disagreement as to the cause and pathogenesis of this disorder subsequently developed. There is also a discrepancy regarding the criteria necessary for the diagnosis of Scheuermann's disease (AKA: Idiopathic Adolescent Spondylodystrophy). Currently the criteria frequently requires the presence of abnormality is at least three contiguous vertebra, each with wedging the five degrees or more. The problem is that cases of Scheuermann's disease are exclude which do not have as prominent anterior wedging. Diagnostic criteria based on the presence of clinical findings are inadequate because many patients with this disorder are entirely asymptomatic.

Most affected persons are between the ages of 13 and 17 years and there is a slight predominance of male patients. Clinical manifestations are highly variable with some people presenting as totally asymptomatic and the radiographic change is discovered as an incidental finding. Clinical manifestations such as achy pain aggravated by physical exertion, fatigue, and tenderness to palpation are commonly encountered. A kyphotic deformity may often be associated with a mild scoliosis, predominately in a thoracic region although it can be observed in the thoracolumbar segments. Neurologic complaints are uncommon, however, there is an increased incidence of herniation of the thoracic intervertebral discs that could lead to neurological manifestations in some cases.

Radiographic abnormalities include irregularity of the vertebral endplates specifically with an undulating superior and inferior surface of affected vertebral bodies associated with Schmorl's nodes with surrounding sclerosis, a loss of intervertebral disc heights, particularly in the mid portion of the kyphotic curvature, and anterior wedging in the same region. Sometimes small osteophytes may be evident identical to the appearance of osteophytes in spondylosis deformans (degenerative disc disease). Radiographically, healing of these lesions can appear as ossification of the anterior portion of the intervertebral disc which, if occurring early, can accentuate the kyphotic deformity. Lateral spinal curvature is also present in Scheuermann's disease due to wedging of the vertebral bodies in the coronal plane or scoliosis in the region of the compensatory lordosis typically below the kyphotic portion. Scoliosis is typically more prevalent in girls.

The pathologic abnormalities in Scheuermann's disease do not reveal osteonecrosis. The importance of genetic factors is supported by reports of familial occurrence. It was suggested that cartilaginous node formation is fundamental to the disease process. When the cartilaginous endplates are congenitally weak it predisposed certain persons to intraosseous discal prolapse during periods of excessive physical stress or repetitive trauma.

A similar process in lumbar spine is so-called juvenile discogenic disease. Juvenile discogenic disease is a fairly common entity, but not much has been written about its features. Like Scheuermann's disease, there is pathology of the endplates that lead to morphologic changes in the osseous and soft tissue components of the spine. Juvenile discogenic disease is characterized by endplate irregularities, large Schmorl's nodes that lead to expansion of the vertebral bodies, primarily in the AP dimension and may be associated with lower L/S degenerative disc disease. There is a tendency for involvement of the upper lumbar region. As in Scheuermann's, there is a predilection for late adolescent boys with a history of repetitive trauma.

It is important to realize that because of the inherently weakened endplates, intervertebral disc herniations, advanced degenerative disc disease, and degenerative joint disease of the facets are common findings, making the central and/or nerve root canals vulnerable to narrowing.

The prognosis is relatively marginal for patients with juvenile discogenic disease due to the high propensity for multilevel disc herniations and advanced onset of severe degenerative disc disease, however, conservative management combined with avoidance of repetitive trauma are typically the best measures.

........... OK, so the diagnosis of this would look to be a SERIOUS detriment to a claim since its been identified as a congenital disease or disorder... but... wasnt there a ruling stating that there basically were no more diseases or disorders that were congenital?

I mean if this is left to stand without any other medical opinion refuting the diagnosis it looks like a claim killer to me unless either, the VA cannot claim it was a congenital defect (which I am unsure of) or it is refuted by current medical evaluation and evidence with supporting physicians statements.

Its one I havent heard of...

anyway someone help with the congenital defect issue cause I cant remember but I thought the ruling went if it wasnt on the entrance physical it couldnt be considered etc.... but I am unsure.

[kris]

Sixthscents and Rickb54 thank you again

Sixthscents that was alot of info I am going to have to read a few times.

Thank you

[sixthscents]

Yeah sorry about the length but I'd never even heard of it, and back injuries are my specialty... so

I really think the claim will hinge on either getting new evidence which clearly refutes the earlier diagnosis, or/and wether or not the VA can consider this as a congenital condition or a pre-existing illness and deny service connection on that basis...

Now I KNOW the was a ruling about that I just cant find it really quick, give me a bit and I'll turn it up...