This is a post that has arisen from a previous post of mine with regards to MMI ratings. My question here is this: Are the AMA guidelines a fixed rating or a guide only for rating? I can't find any information on the AMA guidelines without actually buying the bloody book, which is over $100.

Might I ask, what was wrong with your spine, where, location, and what was done to repair it, like fusion or what? This could make things a lot easier.

If only a discectomy was done, then the rating is fair. If a fusion was done, which you may need soon, because discectomy just removes a piece of the disc and brings the Vertebra's closer together causing pain over again. Then the rating could be slightly higher.

This post was last modified: 09-10-2008 06:31 AM by Bad Boy Bad Boy.

The AMA Guides are a fixed range of values for various degrees of functional impairment and/or diagnoses. A tear as you have described elsewhere adds nothing to the determination in and of itself but may lead to additional functional loss that can increase a rating determination.

I can't wait to have mine done in a couple of weeks. I have injured 5 body parts. All permanant injuries, none as serious as alot here but they are chronic now and painful. Lots of nerve damage (cervical and lumbar) . Surgery only on my shoulder, which made it worse. No surgery for the spine would "fix" it so I'm not a candidate. I'm really curious to see how these injuries are figured out. My state also uses the AMA guidlines. Best of luck BP.........


CAP

Complaint that possibly the AMA 6th Edtion might be less of a rating then the AMA 5th Edition, not so.

It was just a few months back also, where a couple of people were only rated a 5% for the same conditions.

Here is what the 5th Edition states for the type surgery you had; Not much of a difference;

Category III (15-18%)

Lower extremity neurologic impairment related to thoracolumbar injury documented by examination findings of:

Loss of reflexes
Loss of motor strength and/or sensory loss
Muscular atrophy
Neurologic impairment verified by electrodiagnosis
Or:

Significant radiculopathy with disc herniation verified by imaging study
Improvement of radiculopathy following surgery

This post was last modified: 09-10-2008 12:03 PM by Bad Boy Bad Boy.

Something I found awhile back. It is good reading. It may not help much, but anything I find online like this, I try to read and get better knowledgement.

http://www.emedicine.com/pmr/topic170.ht...assessment

The 6th edition is something I came across when looking about on line. Apparently some states are contesting its value since it appears to reduce ratings in favour of the insurance companies.

With regards to the tear, it was found when I had surgery and there was quite a lot of leakage there. The entire nerve in that area was flattened. After about two months I was able to get about and do things without too much pain at all. And there were certainly times when there was no pain at all. Then about four weeks ago I started to have episodes where my back would just seem to get stuck, lots of pain, right down into legs again. After about a week of massage and tens treatment the first episode went. Two weeks later another one, this time much worse and I could feel it creeping up on me about a week prior to the back going out again. This time nothing helped and eventually I had to call the surgeon. Still waiting for the MRI. It was approved yesterday, at least that is what the ic said. Anyhow, though the pain in the back has subsided the left leg is now in constant pain with it dropping or going out completely. Feels like a huge cramp all along the leg. I can't drive for more than about 10 minutes now without the back going into spasm. And all of this with the muscle relaxant that is supposed to be helping. So I don't know what is happening. When I had surgery they also found two Tarlov cysts, which complicated the surgery even further. One had shown on the MRI prior to surgery, the other was a complete surprise and not expected. The tear was of the dura itself.

I had a single level AOMSI with radiculopathy. which means nothing to me at all. Actually it was a discectomy at area L5-S1. However the tear was on the dura and was leaking heavily as well. They also found two Tarlov cycts which complicated the entire issue. The cyst on L5 was seen on the MRI prior to surgery, but the one on S1 was not and was a complete surprise. There was nothing to take out, since the disc had completely disappeared.

I'm confused now;

You stated, (There was nothing to take out, since the disc had completely disappeared.)

So, what did they put in it's place? If nothing, then your Bone on Bone, and needed a Fusion. Something wrong with your Surgeons head or what?

Definately nothing there. The entire disc, at first accident, went into the spinal canal. The surgery was to go into the canal and remove the debris and relieve the nerve that was severly compressed. When the surgeon went into the canal, there was no debris there to remove....and nothing of the disc left at all. So....he did talk of doing a fusion, but we decided to try to avoid that.

Here is what the MRI following surgery said: Interval left L5 laminotomy and left L5-S1 microdiscectomy with abnormal soft tissue signal along the disk margin and extending along the left lateral aspect of the thecal sac that enhances with contrast and compatible with epidural fibrosis: no definite recurrent disk protrusion is identified.

So maybe that means there is something there. Just not much since almost all of it went into the canal.