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No appropriate clinical management for spondylolysis or spondylolisthesis

Document
Last amended 
16 June 2015

Spondylolisthesis and spondylolysis - No appropriate clinical management for spondylolysis or spondylolisthesis Factor

In most cases treatment of spondylolisthesis and spondylolysis will be conservative, will be directed at symptom relief, and will not influence disease progress. Such treatment includes decrease in activities, muscle strengthening exercises, medication and periodic monitoring of symptoms and slippage.

Therefore, in most cases, failure to obtain appropriate clinical management will not result in permanent worsening of the conditions. However in the following cases a lack of treatment could have serious consequences:

  • acute traumatic spondylolisthesis or spondylolysis is defined by the RMA to mean 'spondylolisthesis or spondylolysis arising as the direct result of a severe, high energy trauma to the spine'.  In such cases the required treatment is a combination of traction and cervical supports [where affecting the cervical spine] or surgical reduction of the slip [in cases affecting the lumbar spine];
  • neurological manifestations, such as nerve root entrapment, where surgery is the required treatment, and
  • severe progressive symptoms warranting surgical intervention.

The SOP limits the application of the 'inability to obtain appropriate clinical management' factor to these three situations.

Inability to obtain appropriate clinical management

Last reviewed for CCPS 16 September 2011.

Investigative Documents
Type Title PDF Format Word Format
Medical Report
No appropriate clinical management for spondylolysis or spondylolisthesis
GQACM.pdf
GQACM.docx
Preliminary questions [24398]

24410  the condition under consideration is a type of spondylolisthesis or spondylolysis that may be aggravated by an inability to obtain appropriate clinical management for spondylolisthesis or spondylolysis.

24395 the condition under consideration is acute traumatic spondylolisthesis or spondylolysis.

or

24396 the condition under consideration resulted in neurological manifestations.

or

24397 the condition under consideration resulted in severe progressive symptoms warranting surgical intervention.

11109  the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.

7066     there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

7378     the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.

7379     the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration.

11234   the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.

11235  the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration.

or

11236  the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration.

Clinical worsening and operational service [11235]

7384     the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.

21084 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.

7387     the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

7389     the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

739