J Korean Med Sci.  2009 May;24(Suppl 2):S307-S313. 10.3346/jkms.2009.24.S2.S307.

Korean Guideline Development for the Evaluation of Permanent Impairment of the Spine: Proposal by the Korean Academy of Medical Sciences Committee

• Kim YB
• Lee SG
• Park CW
• Kim DJ
• Park YK
• Sung NJ
• Ahn SH
• Ahn JS
• Shin HS
• Lee BS
• Kim JH
• Jeon CH

• KMID: 1713817
• DOI: http://doi.org/10.3346/jkms.2009.24.S2.S307

Abstract

The criteria for the evaluation of spinal impairment are diverse, complex, and have no standardized form. This makes it difficult and somewhat troublesome to accurately evaluate spinal impairment patients. A standardized guideline was studied for the evaluation of spinal impairment, based on the American Medical Association (AMA) Guides and the McBride method. This guideline proposal was developed by specialty medical societies under the Korean Academy of Medical Sciences. In this study, the grades of impairment were assessed by dividing patients into three different categories: spinal cord impairment, spinal injury impairment and spinal disorder impairment. The affected regions of the spine are divided into three: the cervical region, the thoracic region, and the lumbosacral region. The grade of impairment was differentially evaluated according to the affected region. The restricted range of motion was excluded in the evaluation spinal impairment because of low objectivity. Even though the new Korean guideline for the evaluation of spinal impairment has been proposed, it should be continuously supplemented and revised.

Keyword

Korean Guideline; Spine Impairment; AMA Guides; McBride

MeSH Terms

*Disability Evaluation
Humans
Korea
Program Development
Severity of Illness Index
Spinal Cord Injuries/classification/diagnosis
Spinal Diseases/classification/*diagnosis

Reference

1. McBride ED. Disability Evaluation and principles of treatment of compensable injuries. 1963. 6th ed. Philadelphia: Lippincott Company.

2. Cocchiarella L, Andersson GBJ. Guide to the Evaluation of Permanent Impairment. 1999. 5th ed. Chicago, Ill: Americal Medical Association.

3. Demeter SL, Andersson GB. Disability Evaluation. 2003. 2nd ed. Chicago Ill: Americal Medical Association.

4. Andersson GB. Diagnostic considerations in individual with back pain. Phys Med Rehabil Clin North Am. 1998. 9:2.

5. Andersson GB, Deyo RA. History and physical examination in patients with herniated lumbar discs. Spine. 1996. 21:10S–18S.

6. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994. 331:69–73.

7. Nardin RA, Patel MR, Gudas TF, Rutkove SB, Raynor EM. Electromyography and magnetic resonance imaging in the evaluation of radiculopathy. Muscle Nerve. 1999. 22:151–155.

8. Nitschke JE, Nattrass CL, Disler PB, Chou MJ, Ooi KT. Reliability of the American Medical Association Guides' model for measuring spinal range of motion. Its implication for whole-person impairment rating. Spine. 1999. 24:262–268.

9. American Medical Association. Guides to the Evaluation of Permanent Impairment. 1984. 2nd ed. Chicago, Ill: American Medical Association.

10. Zuberbier OA, Kozlowski AJ, Hunt DG, Berkowitz J, Schultz IZ, Crook JM, Milner RA. Analysis of the convergent and discriminant validity of published lumbar flexion, extension, and lateral flexion scores. Spine. 2001. 26:E472–E478.

11. Foster WS, Hipp JA. Should the AMA change current structural integrity guidelines for rating spinal impairment? Dis Med. 2005. 5:47–49.

12. Mayer TG, Kondraske G, Beals SB, Gatchel RJ. Spinal range of motion: accuracy and sources of error with inclinometric measurement. Spine. 1997. 17:1976–1984.

13. Lee KS. Medical Considerations in Reparation and Compensation. 2002. 4th ed. Joongang Company.