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.

Post-Laminectomy Syndrome


Related Terms

  • Failed Back Surgery Syndrome
  • Failed Back Syndrome

Differential Diagnosis

Specialists

  • Clinical Psychologist
  • Neurosurgeon
  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Pain Medicine Physician/Pain Specialist
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Psychiatrist
  • Rheumatologist

Comorbid Conditions

Factors Influencing Duration

Duration depends on source of pain, underlying cause, and method of treatment. The type and amount of surgery and rehabilitation required have an effect on the duration of disability. Permanent disability may occur for individuals in certain job situations. Psychosocial factors have a significant impact on disability. Chronic opioid therapy may increase duration.

Medical Codes

ICD-9-CM:
722.80 - Post-laminectomy Syndrome, Unspecified Region
722.81 - Post-laminectomy Syndrome, Cervical Region
722.82 - Post-laminectomy Syndrome, Thoracic Region
722.83 - Post-laminectomy Syndrome, Lumbar Region

Overview

Post-laminectomy syndrome refers to the persistence of pain and disability following laminectomy. Laminectomy is a type of back surgery performed to relieve nerve compression (radiculopathy) or nerve root injury in the spine caused by disc herniation or spinal canal narrowing (spinal stenosis) related to degenerative changes.

The spinal canal is formed by the posterior (back) portion of the vertebrae that surround the spinal cord and protect and confine the spinal nerves. A disc herniation or spinal stenosis may occur and cause pressure on the spinal cord and/or one or more spinal nerve roots. Removing a section of the bony arch, or lamina, which forms the posterior part of the spinal canal (laminectomy) allows for decompression of the nerves.

Post-laminectomy syndrome specifically refers to pain associated with symptoms not relieved following laminectomy. However, the term often is used more broadly to describe poor outcomes following any type of spinal surgery. The classic term laminectomy often is used to describe a partial laminotomy, which is removal of only a portion of the lamina to provide access to a disc herniation. The most frequent surgery preceding a diagnosis of post-laminectomy syndrome is lumbar discectomy. Spinal surgery may be performed in patients who do not improve with nonsurgical (conservative) treatment, even though surgical results are less predictable in the absence of correlation between specific clinical findings and imaging study results. In those cases, decompression may fail to provide relief, and the result is post-laminectomy syndrome.

The causes of poor results or failed back surgery syndrome, a term inclusive of post-laminectomy syndrome and persistent pain after other spinal procedures, including spinal fusion, include poor patient selection (i.e., operating when nerve compression did not exist), nerve root injury at the time of surgery, delayed surgery, infection in the disc space or epidural space, unrecognized lateral spinal stenosis or instability, arachnoiditis, and reherniation. Rarely, the first surgery will have been performed on the wrong side or at the wrong level (malpractice). Surgery may have been performed appropriately and the pathology corrected; however, psychosocial factors may contribute to chronic pain that develops after surgery.

Incidence and Prevalence: About 450 cases of herniated disc per 100,000 require surgery in the US (Sleigh). Incidence of post-laminectomy syndrome correlates with data on the number of surgeries performed, of which an estimated 10% to 15% are considered unsuccessful (Wheeler).

Source: Medical Disability Advisor






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