| Rating Criteria | Rating Percentage |
|---|---|
| With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease: | |
| Unfavorable ankylosis of the entire spine | 100 |
| Unfavorable ankylosis of the entire thoracolumbar spine | 50 |
| Unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine | 40 |
| Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine | 30 |
| Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis | 20 |
| Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height | 10 |
Note (1): Evaluate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code.
Note (2): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, entire thoracolumbar spine, or entire spine is fixed in flexion or extension, and the fixation results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis.
Note (3): In exceptional cases, an examiner may state that because of age, body habitus, or other factors not the result of disease or injury of the spine, the range of motion values for that individual should be considered normal, even though they differ from the typical range.
Note (4): Round each range of motion measurement to the nearest five degrees.
Note (5): For VA compensation purposes, the normal forward flexion of the cervical spine is 0 to 45 degrees, extension is 0 to 45 degrees, lateral flexion is 0 to 45 degrees, and lateral rotation is 0 to 80 degrees. The normal forward flexion of the thoracolumbar spine is 0 to 90 degrees, extension is 0 to 30 degrees, lateral flexion is 0 to 30 degrees, and lateral rotation is 0 to 30 degrees.
Note (6): When evaluating under this general rating formula, use the diagnostic code that represents the predominant disability. Diagnostic code 5243 (Intervertebral Disc Syndrome) may also be evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever results in a higher evaluation.