Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Cervical Disc Disorder with Myelopathy

cervical disc disorder with myelopathy in 中文(中华人民共和国)

Related Terms

  • Cervical Radiculopathy
  • Cervical Spondylosis
  • Cervical Spondylotic Myelopathy
  • Degenerative Disc Disease (DDD)

Differential Diagnosis

Specialists

  • Anesthesiologist
  • Neurologist
  • Neurosurgeon
  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist

Factors Influencing Duration

The length of disability depends on the severity and duration of spinal cord compression, the severity of persistent sensory and motor problems, the presence of absence of incontinence, whether surgery was performed, and, if so, whether a fusion was included, which requires time for the fusion to occur. Length of disability will also depend on whether nonsurgical treatment regimens are followed, the age and health status of the individual, and the individual's response to treatment.

Duration also depends on how much neck extension is necessary when performing work that calls for the arms to be elevated above shoulder level. Even with improvement after treatment, persistent myelopathy is usually incompatible with heavy work.

Medical Codes

ICD-9-CM:
721.1 - Cervical Spondylosis with Myelopathy; Anterior Spinal Artery Compression Syndrome; Spondylogenic Compression of Cervical Spinal Cord; Vertebral Artery Compression Syndrome
722.4 - Cervical Disc Degeneration
722.71 - Cervical Disc Disorder with Myelopathy
723.4 - Brachial Neuritis or Radiculitis NOS; Cervical Radiculitis; Radicular Syndrome of Upper Limbs

Overview

© Reed Group
Myelopathy is an inclusive term referring to any disease of the spinal cord. For example, when due to trauma, it is known as spinal cord injury; when inflammatory, it is myelitis, and when vascular, it is labeled vascular myelopathy.
The cervical region specifies the neck region of the spine. The following are examples of myelopathy: carcinomatous myelopathy (spinal cord degeneration associated with cancer); compressive myelopathy (spinal cord changes from the pressure of hematomas or masses); and radiation myelopathy (spinal cord destruction from radiation sources such as x-ray therapy). When the spinal cord destruction is caused as a complication of disease, the specific myelopathy signifies that origin; for example, diabetic myelopathy.

Cervical disc disorder with myelopathy can result from either a herniation of a cervical disc or spinal cord compression by spinal stenosis. A cervical disc (intervertebral disc) is a cushion-like structure found between the cervical spinal bones (vertebrae C2 through C7) that run from the base of the skull to the upper back. Discs are composed of a gel-like inner material (nucleus pulposus) encased in a ring of tough, fibrous outer material (annulus fibrosis); intervertebral discs absorb shock and allow movement of the spine. Disc displacement (herniation) occurs when the nucleus pulposus and / or the annulus protrudes abnormally into the spinal canal. Most often, a disc herniation presses on an exiting spinal nerve, causing dysfunction in a nerve root (radiculopathy). Less commonly, the spinal cord can become compressed by a herniated or protruding disc alone, or in combination with degenerative bony changes (cervical spondylosis) or with a narrow spinal canal (spinal stenosis).

Cervical disc herniation with myelopathy is less common than cervical disc herniation without myelopathy. Although both disorders cause neck pain and disturbances in arm sensation and strength, myelopathy is a more critical problem, frequently also involving neurological disturbances in the legs and possible impairment of bowel and / or bladder control.

Individuals with cervical disc disorder and myelopathy show signs and symptoms of myelopathy, with or without radiculopathy. Symptoms of radiculopathy (nerve root dysfunction) typically include pain radiating into the arm or chest with arm and / or finger numbness and motor weakness in an arm.

Blood supply to the brainstem and posterior fossa brain structures can also be affected by vertebral artery compression from spondylosis and may include dizziness, syncope, blurred vision, ringing in the ears (tinnitus), and pain behind the eyes. Like radiculopathy or arm symptoms, these brain stem symptoms may coexist with the symptoms of spinal cord compression that define myelopathy.

Discs normally begin the degeneration process by at least the third decade of life; by the fifth decade of life, most individuals exhibit degenerative changes (Windsor). Nevertheless, many individuals have no symptoms, and over the years these degenerative changes can slowly narrow the spinal canal until myelopathy occurs.

Myelopathy can also begin suddenly in the aftermath of a massive cervical disc rupture. Individuals who develop very rare acute cervical disc herniation with myelopathy as a result of injury often participate in sports that place a vertical load on the cervical spine, such as soccer, football, wrestling, ice hockey, diving, rugby, and trampolining.

Incidence and Prevalence: One in five visits to an orthopedic practice is for cervical discogenic pain (Windsor). Eight percent of all herniated discs occur in the cervical region of the spine. Cervical spondylotic myelopathy is the most frequent cause of spinal cord dysfunction in individuals older than 55 years in the US and worldwide (Al-Shatoury).

Degeneration of cervical intervertebral discs accounts for 36% of all spinal intervertebral disc disease, second only to lumbar disc disease, which accounts for 62% of all spinal intervertebral disc disease (Windsor).

Source: Medical Disability Advisor






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