Body system: Musculoskeletal SystemRegulation: 38 CFR § 4.71aDBQ: DBQ MUSC Back (thoracolumbar spine); DBQ MUSC Neck (cervical spine)
Spondylolisthesis is when one of your vertebrae (spine bones) slips forward or backward over the one below it. Segmental instability means parts of your spine move too much and cannot properly support your body weight. The VA rates this condition under the General Rating Formula for Diseases and Injuries of the Spine, the same ladder used for every condition coded 5235-5243 (except intervertebral disc syndrome rated under the Incapacitating Episodes formula). Ratings run from 10% to 100% based on how far you can bend forward, your total spine range of motion, muscle spasms or guarding, and whether any part of your spine has fused (ankylosis). Higher ratings apply when spine movement is severely limited or when entire spine segments fuse in a bad position.
Rating levels
- 100% — Your entire spine has fused together in a bad position that severely limits your ability to move your back and neck (unfavorable ankylosis means the bones have grown together abnormally). This complete fusion makes it extremely difficult or impossible to bend, twist, or turn your spine in any direction, significantly impacting your daily activities and quality of life.
- 50% — Your entire middle and lower back spine has fused together in a way that severely limits your movement and function. Unfavorable ankylosis means the vertebrae (spine bones) have grown together abnormally, creating a rigid, inflexible spine that significantly restricts your ability to bend, twist, or move your back normally.
- 40% — You qualify for this rating if your entire neck is fused or locked in place in a bad position (unfavorable ankylosis), or if you can only bend forward 30 degrees or less in your mid to lower back, or if your entire mid to lower back is fused in a good functional position (favorable ankylosis). Ankylosis means your spine joints have become stiff and immobile, either naturally from your condition or surgically fused together.
- 30% — You qualify for this rating if your neck can only bend forward 15 degrees or less (normal is about 50 degrees), or if your entire neck spine has fused together in a good position (favorable ankylosis means the bones have grown together but in a way that doesn't cause major problems). This represents severe limitation in neck movement that significantly restricts your ability to look down or bend your head forward.
- 20% — You qualify for this rating if your back or neck injury limits how far you can bend forward - either bending your back forward between 30-60 degrees or bending your neck forward between 15-30 degrees. You also qualify if your overall spine movement is significantly restricted (back movements totaling 120 degrees or less, neck movements totaling 170 degrees or less), or if you have severe muscle spasms that cause you to walk abnormally or develop visible spine curvature like a hunched back, loss of natural back curve, or sideways spine curvature.
- 10% — You qualify for this rating if your spine injury limits how far you can bend forward - either to about shoulder height for your lower back or chin-to-chest level for your neck. You also qualify if you have muscle spasms, stiffness when moving (guarding), or tender spots along your spine that don't cause you to walk differently or change your spine's normal curves. Additionally, you qualify if X-rays show a vertebral fracture where the bone has collapsed by half or more of its original height.