Disorders of the Spine

A. Definition

The spinal cord is the main pathway of communication between the brain and the rest of the body. It is a long, fragile, tube-like structure that extends downward from the base of the brain. The cord is protected by the back bones (vertebrae) of the spine (spinal column). The vertebrae are separated and cushioned by discs made of cartilage.

Causes of spinal cord disorders include injuries, infections, a blocked blood supply and compression by a fractured bones, swelling, hematomas, or tumors.

B. General information

The spine is divided into four sections, and each section is referred to by a letter.

  • Cervical (C): Neck
  • Thoracic (T): Chest
  • Lumbar (L): Lower back
  • Sacral (S): Pelvis

Each segment of the spine is crucial to the well-being of the entire spinal column and cord since the strength of each portion is contingent upon the other vertebrae and discs to function properly. Through time, the spine may be subjected to constant stress, repetitive or high impact injuries, diseases, and arthritis. These conditions can cause pain, degeneration, and lack of function.

If the spine is injured, you will likely feel pain in the affected part of your neck or back. The area over the injury may be tender to the touch, particularly if a fracture is present. If the spinal cord is injured, the nerves at and below the site of the injury malfunction, causing loss of muscle control and loss of sensation. However, children may have spinal cord injuries in which nerves malfunction only temporarily and briefly. They may have lightning-like pains that shoot down the arms or legs.

When nerve damage occurs, loss of muscle control or sensation may be temporary or permanent, partial or total, depending on the severity of the injury. An injury that severs the spinal cord or destroys nerve pathways in the spinal cord causes permanent loss, but a blunt injury that jars the spinal cord may cause temporary loss, which can last days, weeks, or months. Sometimes swelling causes symptoms that suggest an injury more severe than it is, but the symptoms usually lessen as the swelling subsides.

Partial loss of muscle control results in muscle weakness. Paralysis usually refers to complete loss. When muscles are paralyzed, they often go limp (flaccid), losing their tone. Muscle reflexes that doctors check using a reflex hammer are weak or absent. But when the spinal cord is injured, paralysis may progress weeks later to involuntary, prolonged muscle spasms (called spastic paralysis). In this case, muscle reflexes are stronger than normal.

Chronic, severe back pain is a leading cause of disability. The Social Security Administration recognizes that a spinal disorder can preclude competitive employment for a year or longer and has outlined criteria for disability in its Listing of Impairments.

C. Social Security Medical Listing 1.04 – Disorders of the Spine.

To be found disabled by the Social Security Administration due to a herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, or vertebral fracture, you must prove:

A. Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, a positive straight-leg raising test from the seated and supine positions; or
B. Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every two hours; or
C. Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic non-radicular pain and weakness, and resulting in inability to ambulate effectively.

The “inability to ambulate effectively” means an extreme limitation of the ability to walk; i.e., an impairment(s) that interferes very seriously with your ability to independently initiate, sustain, or complete activities. Ineffective ambulation is defined generally as having insufficient lower extremity functioning, precluding independent ambulation without the use of a hand-held assistive devices, which limit the functioning of both (two) upper extremities.

Your representative can help you determine whether your impairment is severe enough to qualify for Social Security Administration disability benefits.