tdiu Va: Mri Lumbar Spine=small Osteophytes

[3 years to retire]

Hello

I went to my VA dr. who sent me in for a MRI for my lower back. ("56y/o man with chronic low back pain he has a mass in left sacroiliac region..)

The MRI report :

Small osteophytes are present anterior to the spine at all levels from L1 through L5. No other bone or disc admormality noted. There is no evidence of foraminal or spinal stenosis.

Impression: Small osteophytes anterior to the lumbar spine as described above>

So what I have found in research is that the osteophytes are bone spurs:

bone spurs usually occur as the result of a disease or condition - most commonly osteoarthritis

bone spurs form in places where they might rub against other bones or push against nerves causing pain and disability.

My questions are:

since the report stated that there was no evidence of foraminal or spinal stenosis, can someone explain to me what that means?

Also, there was no mention of arthritis in this report. Which is what I feel is the cause of the bone spurs. I have both knees with arthritis (va connected) now.

Also, how should I proceed, can this lead up to unemployability (100%) since I am ready to retire in 9 months, it would be very helpful to be raised to 100%. I am currently at 40%, on both of my knees?

Thanks...

[3 years to retire]

Hello

I went to my VA dr. who sent me in for a MRI for my lower back. ("56y/o man with chronic low back pain he has a mass in left sacroiliac region..)

The MRI report :

Small osteophytes are present anterior to the spine at all levels from L1 through L5. No other bone or disc admormality noted. There is no evidence of foraminal or spinal stenosis.

Impression: Small osteophytes anterior to the lumbar spine as described above>

So what I have found in research is that the osteophytes are bone spurs:

bone spurs usually occur as the result of a disease or condition - most commonly osteoarthritis

bone spurs form in places where they might rub against other bones or push against nerves causing pain and disability.

My questions are:

since the report stated that there was no evidence of foraminal or spinal stenosis, can someone explain to me what that means?

Also, there was no mention of arthritis in this report. Which is what I feel is the cause of the bone spurs. I have both knees with arthritis (va connected) now.

I am currently at 40%, on both of my knees?

Thanks...

Hello again.

Well I went to a orthapedic back specialist, a 'spine specialty center' to get a medical opinion. I took a copy of my VA mri film and the written report. I also took a copy of my Va and private Dr reports on my knees.

I got his opinion yesterday. I am hoping to hear from ya'll to see if it will help me tied my service connection (knee ) to my back pain. Here is a brief of his report.

Subjective: Chief complaint back pain

HPI: this is a gentleman with a bad knee he is doing a lot of limping he is here with a lot of back pain that he feels is related There was no particular injury that he recalls to the back He wonders if these two problems are related

Impression:

1- Myofascial buttock pain on the left side This is likely related to an antalgic gait

2-Multilevel lumbar degenerative disc changes and mild congential lumbar spinal stenosis

3-Annular tear

Plan

Based on the patient's present symptioms I truly think his pain, especially his buttock symptoms is more related to the limp that he is having. I told the patient I do not feel his degenerative changes are likely related to this but can certainly account for his backpain based on his gait.

So that is the compact version of the medical opinion. I feel that he did not hurt me but how much did he help me? I am trying to tie the back pain - which I assume was bone spurs - to my left knee and the gait. I think the dr is saying the back pain or buttock pain is not from the bone spurs so much, but is from the limp (gait) I have due to my left knee with is service connected.

Does anyone feel this is enought to file for a claim of secondary service connection?

Should I try to find another medical opinion or is this strong enought?

Any suggestions on how to proceed...

Thanks.

[Vike17]

3 years,

I hate to say it, but this opinion really is worth much. A few things that are missing which is crusial toa IMO;

1) Doctor didn't give an clinical diagnosis for the knee condition

2) The Doctor didn't give a full rational for why he thought your knee has caused your back condition. A rational can usually be done by cititng medical litrature and referencing "Objective Finding"

3) Doctor didn't use the phrase "at least as likely as not" in case there would be the need for "Reasonable Doubt" and the evidence was in equal balance for your claim and against it.

4) The doctor should state what area his expertise is in and he should list any special qualifications he may have such as being board certified in something.

5) The doctor must state he reviewed your entire health records to include your SMR'S if the knee isn't already service-connected

You may want to have the doctor review his own write-up to see if he can say, with the above listed things I mentioned, if your knee is the cause of your back problems.

Vike 17

[LarryJ]

I might also add that I know there are different opinions vis a vis Dr. Bash.

Without getting into whether you like or dislike him, one thing is for certain, this is definitely his area of expertise.

just sayin.......

[allan]

Spinal stenosis

http://www.nlm.nih.gov/medlineplus/ency/article/000441.htm

Definition

Spinal stenosis is a narrowing of the lumbar (back) or cervical (neck) spinal canal, which causes compression of the nerve roots.

Causes, incidence, and risk factors Return to top

Spinal stenosis mainly affects middle-aged or elderly people. It may be caused by osteoarthritis or Paget's disease or by an injury that causes pressure on the nerve roots or the spinal cord itself.

Symptoms Return to top

Pain in the buttocks, thighs or calves that is worse with walking or exercise

Numbness in the buttocks, thighs or calves, that is worse with standing, walking or exercise

Back pain that radiates to the legs

Weakness of the legs

Neck pain

Leg pain

Difficulty or imbalance when walking

Signs and tests Return to top

An examination of reflexes of lower legs reveals asymmetry. Neurologic examination confirms leg weakness and decreased sensation in the legs.

X-ray of the spine shows degenerative changes and narrowed spinal canal.

Spinal MRI or spinal CT scan shows spinal stenosis.

EMG may show active and chronic neurological changes.

Treatment Return to top

Generally, conservative management is encouraged. This involves the use of anti-inflammatory medications, other pain relievers, and possibly steroid injections. If the pain is persistent and does not respond to these measures, surgery is considered to relieve the pressure on the nerves.

Surgery is performed on the neck or lower back, depending on the site of the nerve compression.

Expectations (prognosis) Return to top

If the nerve roots can be successfully relieved of pressure, the symptoms will not worsen and may improve.

Complications Return to top

Injury can occur to the legs or feet due to lack of sensation; infections may progress because pain related to them may not be felt. Changes caused by nerve compression may be permanent, even if the pressure is relieved.

Calling your health care provider Return to top

Call your health care provider if symptoms suggestive of spinal stenosis develop.

Update Date: 5/31/2006