Lumbar Ddd, Need Help.

[Yong]

Hi,

I am new on the board.

I need help on understanding my MRI result and what to expect from VA Claim.

I'd just retired from the Army and I was diagnosed with DDD just before I got out.

MRI dated 26 Oct 2006 states that I have following problems in my lumbar spine;

Diffuse degenerative disc desciccation without significant loss of disc height from L2-L3 through L5-S1.

L2-L3 diffuse annular bulge with a small posterior annular tear mildly indenting the ventral thecal sac and causing mild spinal canal narrowing. The neural foramina are patent.

L3-L4 posterior annular buldge with small central to right paracentral disc protrusion causing mild to moderate spinal narrowing. There is disc contact with the right L4 nerve root in the lateral recess, which is asymmetrically larger relative to the left.

L4-L5 posterior disc protrusion-endplate osteophyte complex, bilateral facet and ligamenta flava degenerative change, which result in mild to moderate spinal canal and moderate right lateral recess/ subarticular zone narrowing. There is disc osteophte contact with the bilateral L5 nerve roots, worse in the right.

L5-S1 bilateral facet hypertrophy and posterior disc and endplate osteophte complex, but no significant spinal or neural foraminal narrowing, nor nerve root displacement.

My Dr. in service told me that one out of 4 people at age 40 develope this problem. He also stated that unless I have hard time walking, I should control the symtems with pain medication (Roxicet, Mobic, Flexeril, and Prednesone).

Need Help!!!!

[rdawg]

sorry, side to side is called flex. rotation is called rotation. I knew it was a conspiracy.

[Yong]

Vike 17,

Thanks for the info.

On good days, I can bend normal. However, on bad days, I can only bend half way. I am not sure what my flexion or extension is. My back had been hurting for many years but I had not seen the Dr. till resently because I did not want to be sick ranger. So, only limited documentation is in my SMR.

For past 12 months, my back had been hurting for 1-2 times a month, lasting 1-2 weeks at a time.

Only few of these been documented. I have no documentation of bed rest from the Dr.

With current pain I am experiencing, I don't think I could work on the same job that I had in the service "mechanic".

[rdawg]

I only did 4 years as a mechanic in the AF. Worked for 10 more as a quasi mechanic but couldn't do it anymore. I retrained myself in computers and have been a software engineer for 8 years now. The back still hurts alot, not from lifting but from sitting.

[Nathan104]

Im trying to understand the ROM degrees.

So, standing up straight is 0 degrees and if you bend forward to where your upper torso is parallel with the ground then you are at 90 degrees? And that is what "forward flexion" is? Am I getting it right?

Edited February 1, 2007 by Nathan104

[Yong]

I looked through my SMR and noticed that Dr. from physical therapy had wrote Flex = WNL and Extension = 25% of normal. ?????

Is anyone here from PI?

I am looking for a friend, Airforce MSgt retired 2006 from Hawaii and returned to PI. His nickname is the DOM.

If anyone know this person, please let him know that his friend is looking for him.

[sixthscents]

Normally I would have jumped on this but I have been sick... heck our whole community is sick - schools all closed etc. Anyway, as usual Vike 17 is abslutely correct - BUT, the VA can and does do extra-schedular rating for back injuries. That means they CAN (not will but CAN) go outside the normal rating tables.

The thing about a back injury is it causes problems all over. The VA does rate the seperate areas of the spine (cervical, throasic, and lumbar) and recognizes each as an individual major joint. This is also in addition to the problems associated with disk injury and that is covered by IVDS (Intravertabrate Disk Syndrome) as also included below by Vike.

Now the question arises should I have surgery... well I have and it was unsuccessful. To be honest the majority of LUMBAR surgeries are unsuccessful from what I have seen, while the CERVICAL surgeries enjoy a much higher success rate - I had that too. So, my reccomendation would be to put off surgery as long as possible IF YOU ARE NOT HAVING NEUROLIGAL SIDE EFFECTS... note thats in caps because its important. If you are having neurological side effect like numbness, and tingeling, inability to plantar or dorsi-flex you feet or loss of deep tendon reflexes then you spinal nerve branch is being impinged. That essentially means that blood flow thru the nerve is being constricted. What happened to me was I took a VERY conservative approach and eventually the nerve sheath was severed.. Thats what carries all the info to the limb, the center part of the nerve essentially is what holds it together. So, if you are having neurological symptoms that I suggest you consider the benefits and risks very seriously.

There were some terms in you MRI I thought I might explain....

disk narrowing or canal narrowing is just another way of saying that someting is putting pressure upon you spinal chord... and pushing it inward.

forimina is also called bone spurs, is an arthritic condition that basically develops calcium deposits which then can also impinge into the nerve root, etc.

essentially from your MRI I think you probably have a very good claim for lumbar, and IVDS if they are in fact related to your service. I would probably suggest that you have an EMG done... its fairly NON-invasive, unlike a myleogram which is very invasive and can give you a good picture of what is going on with the actual nerves, and which are affected.

So that would be my recomendation at this point, ask for a nerve velocity, or EMG test. Then take the results of that and you will have a clearer picture of what is going on. Also an MRI of your cervical spine is probably in order as well. Further you need to look through you medical records from service and make sure there is a connection - or if you are within one year of discharge simply file and service connection is presumptive.

Edited February 1, 2007 by sixthscents