Spinal Degeneration & Back Injuries

10/12/2012 in Treatment, Medical Conditions
Spinal degeneration is a normal part of the aging process. Research shows that 90% of males over the age of 50, and 90% of females over age 60 have radiographic evidence of degeneration. This degeneration progresses with age and occurs in all of the structures comprising the spinal unit, including intervertebral disks, facet joints, and the connectingligaments. Other factors can influence the rate of spinal degeneration. Among those are environmental factors (such as cigarette smoking or disk injury), and physiologic factors (genetics). Areas of degeneration are likely to be dispersed across the spine and generally correspond to the mechanical stresses produced by spinal motion and posture. Research indicates that the process of spinal degeneration can be hastened by performing tasks involving heavy labor. On the other side of the spectrum, lack of activity can also hasten the degenerative process. Statistically, there is an increased frequency of spinal pain and disk herniation in heavy laborers. It appears that regular moderate exercise is important to slowing down degenerative affects. DEGENERATIVE EFFECTS ON BACKINJURIESSpinal degeneration can contribute to the severity or slow down the healing process of a back injury. Likewise, a back injury can also hasten the degenerative process. Fortunately, the advancement of diagnostic technology has greatly enhanced the ability to determine the length of presence and severity of spinal degeneration. This makes it easier for doctors to determine how the symptomatology and healing process of the injury is affected by the degenerative process. DETERMINING PERMANENCYIn cases where the claimant has sustained permanency for an injury with diagnostically documented degenerative changes, it is important that the doctor assessing permanency delineates between any preexisting degeneration which may be present and the claimed work injury. This becomes more complicated in cases where claimants are performing heavy labor. Degeneration could be prematurely caused or accelerated beyond its normal progression depending upon the length of time the heavy labor was performed. Often, this is dependent upon the type of work performed and the length of time it was performed. The medical professional also needs to consider the role environmental factors, physiological factors, and the claimant's age play in the degenerative process.THE IMEWhen obtaining IME's for back injury claims, it is important to address any preexisting conditions and/or occupational exposure in your cover letter to the evaluating doctor. Point out any preexisting degeneration you may be aware of, let the doctor know if the claimant has a history of performing heavy labor (make sure you let the doctor know if it was for your employer, or a previous or subsequent employer). Also let the doctor know of any environmental or physiological factors you are aware of. These important dynamics will assist the IME doctor in the determination of causation as well as permanency issues.Providing medical documentation is imperative. If you have any records which discuss preexisting degeneration or previous back injuries, those need to be specifically highlighted for the IME doctor in the cover letter. It would be extremely beneficial if those records could be obtained an provided for the IME. Typically, these types of cases are scheduled with orthopedic surgeons; however, neurosurgeons are qualified to conduct IME's for back injuries as well. For most cases, it would be suggested to schedule with an orthopedic surgeon unless it is an injury to the cervical spine. For more information about the reasoning behind this go to www.MedicalSystemsUSA.com or call 1.800.261.3278.]]>

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