Lumbar radiculopathy dbq

Function: Support and compression of abdominal wall and lower thorax; flexion and lateral motions of spine; synergists in strong downward movements of arm (1). Muscles of the abdominal wall: (1) Rectus abdominis; (2) external oblique; (3) internal oblique; (4) transversalis; (5) quadratus lumborum. Severe. 50.

Lumbar radiculopathy is a condition when a spinal nerve root gets pinched and becomes inflamed. The lower back nerve pinch can directly contribute to sciatic nerve pain. If the veteran is dealing with both conditions, they may be able to combine the sciatica rating with the lumbar radiculopathy VA rating to ultimately receive more benefits. ...Lumbosacral radiculopathy is a term used to describe a pain syndrome caused by compression or irritation of nerve roots in the lower back. It can be caused by lumbar disc herniation, degeneration of the spinal vertebra, and narrowing of the foramen from which the nerves exit the spinal canal.The Back and Spine Overview . The VA awards disability compensation for each Back and Spine condition that is service-connected.The DoD will also rate service-connected conditions as long as they also make the service member Unfit for Duty.For Reservists, the condition must have occurred in or resulted from an injury in the Line of Duty to qualify.. …If they are checking for radiculopathy while examining for a lumbar claim, yes, it is the same DBQ. If you were going for increases on existing ratings on leg nerves, there is a separate DBQ just for the nerves. Sounds like your hubby will be doing the first one since they mentioned thoracolumbar spine. Is the DDD already service connected?diagnosis of mechanical low back pain. ***** question 2 of 4::please complete section four and the evidence review in the medical opinion dbq and state whether the veteran's left shoulder condition, if found, was at least as likely as not (50 percent or greater probability) incurred in or caused by an event, illness, orApr 27, 2020 · None Swelling Disturbance of locomotion. Less movement than normal due to ankylosis, limitation or blocking, adhesions, etc. Deformity Interference with sitting. More movement than normal due to flail joints, fracture nonunion, etc. Atrophy of disuse Interference with standing.

Cervical Radiculopathy Symptoms. Cervical radiculopathy signs and symptoms typically include pins-and-needles tingling, numbness, and/or weakness in the areas served by the affected nerve root. In addition to these neurological deficits, pain is also present in most cases. These signs and symptoms may be felt in one area only, such as the ...Sciatica, also called lumbar radiculopathy, is a pain that originates along your sciatic nerve. This nerve extends from the back of your pelvis down the back of your thigh. ... Lower back pain that radiates or spreads down your buttock and the back of one thigh. Pain that extends from your buttock down to your foot. Numbness (in severe cases)Note: For purposes of this examination, the diagnoses of IVDS and radiculopathy ... lumbar disc disease, and neck and arm or hand ... Electromyography (EMG) studies ...The DBQ may be insufficient if you are guarding. The question then becomes has the guarding caused abnormal contour. It MIGHT be worth it getting a private medical exam or asking your private doctor about all of this, then if they are like yeah you are guarding and that caused scoliosis, submit it with a supplemental claim calling the prior DBQ …Radiculopathy is a common service-connected disability caused by a pinched nerve root in either the cervical, thoracic, or lumbar spine. Often, Veterans' rad...

The primary cause of sciatica (present in about 90 percent of cases) is spinal disc herniation pressing on one of the lumbar or sacral nerve roots. Sciatica itself actually refers to a symptom rather than a specific disease. The symptom is likely caused by a lumbar or sacral radiculopathy secondary to degenerative disc disease. SymptomsWhat makes the dbq for lumbar radiculopathy legally valid? As the world takes a step away from in-office work, the execution of documents increasingly takes place electronically. The dbq radiculopathy isn’t an exception. Working with it using electronic tools differs from doing this in the physical world.In this video Leah explains radiculopathy and its relevance to VA disability. She describes radiculopathy as a condition characterized by numbness, pain, and...Edit Va dbq for radiculopathy. Easily add and highlight text, insert pictures, checkmarks, and signs, drop new fillable areas, and rearrange or delete pages from your document. Get the Va dbq for radiculopathy completed. Download your adjusted document, export it to the cloud, print it from the editor, or share it with other participants via a ...Radiculopathy is the name for any nerve group dysfunction. You have various nerve groups running down from your back into your legs. Sciatica is the most common nerve group to be pinched by a lower back injury. The femoral nerve group is another one AND can be rated separately from sciatica which is why some veteran have 2 radiculopathy ratings ...

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Here is how the VA rates for the common peroneal nerve (Diagnostic Code 8521): 40% rating for peripheral neuropathy - Complete paralysis of the nerve. Complete loss of movement and feeling in the nerve that controls the foot. Difficulty lifting the front part of your foot, and cannot bend your foot upwards.The Department of Veterans Affairs encourages all Veterans to submit their private medical records for consideration during the processing of their benefits claim. VA values evidence from your private treatment providers because they are familiar with your medical history, often over a long period of time. VA appreciates the trusted and special ...Secondary conditions develop as a result of an underlying condition or injury. In many cases, lower back pain is caused by spine, discs, or nerve damage. This damage can occur due to an accident, disease, or overuse. While lower back pain is often treatable, it can lead to chronic pain and disability if left untreated.With diseases, preference is to be given to the number assigned to the disease itself; if the rating is determined on the basis of residual conditions, the number appropriate to the residual condition will be added, preceded by a hyphen. Thus, rheumatoid (atrophic) arthritis rated as ankylosis of the lumbar spine should be coded "5002-5240."

Favorable angle in full extension or in slight flexion between 0 and 10 degrees. In flexion between 10 and 20 degrees. In flexion between 20 and 45 degrees. Extremely unfavorable, in flexion at an angle of 45 degrees or more. 5B. Indicate angle of ankylosis in degrees. degrees N/A no ankylosis of knee joint. 5C.Feb 4, 2021 · MRI of the lumbar spine w/o contrast A. Sagittal T2 w/o contrast MRI lumbar spine shows a large 9 mm L5/S1 paracentral disc protrusion with mass effect on the thecal sac. B. Axial T2 w/o contrast MRI lumbar spine; the same patient shows compression of the right exiting S1 nerve root, which has caused this patient to experience right S1 ... Cervical radiculopathy is a clinical condition characterized by unilateral arm pain, numbness and tingling in a dermatomal distribution in the hand, and weakness in specific muscle groups associated with a single cervical nerve root. It is caused by nerve root compression in the cervical spine either from degenerative changes or from an acute soft disc hernation.Neck pain stiffness and radiculopathy. Radiculopathy due to a compressed nerve in the cervical spine can leave veterans with numbness, weakness, tingling in the shoulders, or progress along the entire arm and into the hand or fingers. Many veterans with cervical radiculopathy experience degenerative changes in their spine that cause a herniated ... Question. My C&P for my back was favorable. Just a simple question. The provider diagnosed and put lumbar radiculopathy down both legs in my DBQ. Sciatica CHECKED OFF: Moderate constant pain mild paresthesias mild numbness. Is this 20% down each leg or 10%? It is very vague in the rating schedule. The primary cause of sciatica (present in about 90 percent of cases) is spinal disc herniation pressing on one of the lumbar or sacral nerve roots. Sciatica itself actually refers to a symptom rather than a specific disease. The symptom is likely caused by a lumbar or sacral radiculopathy secondary to degenerative disc disease. SymptomsThe Nerves of the Low Back and Legs Overview . The VA awards disability for conditions of the Nerves of the Low Back and Legs that are service-connected.The DoD will also rate service-connected conditions as long as they also make the service member Unfit for Duty.For Reservists, the condition must have occurred in, or resulted from an injury in, the Line of Duty to qualify.IVDS is rated under diagnostic code 5243, and the rating criteria relies on the number of incapacitating episodes and how much bed rest the veteran's physician prescribed within the last year. The ratings range from 10% to 60%. 10% - "With incapacitating episodes having a total duration of at least one week but less than 2 weeks during ...In this video Leah explains radiculopathy and its relevance to VA disability. She describes radiculopathy as a condition characterized by numbness, pain, and...Edit Va dbq for radiculopathy. Easily add and highlight text, insert pictures, checkmarks, and signs, drop new fillable areas, and rearrange or delete pages from your document. Get the Va dbq for radiculopathy completed. Download your adjusted document, export it to the cloud, print it from the editor, or share it with other participants via a ...INTRODUCTION. Low back pain (LBP) is one of the most frequently experienced medical conditions in the general population, with up to 84% of adults in the United States (U.S.) experiencing LBP at some point in their lives. 1 In 2010, of all diseases and injuries contributing to disability-adjusted life years in the U.S., LBP was ranked third. 2 In 2012, approximately 27.5% of adults 18 years ...Here are the results of my back exam w/ radiculopathy. I BOLD the measurements for easier reading. Please tell me what I might expect. I am EXTREMELY nervous. Diagnosis #1: Scoliosis, thoracic and lumbar ICD code: M41 Date of diagnosis: SC b. Does the Veteran report flare-ups of the thoracolumbar spine (back)? [X] Yes [ ] No

16. Jun 04, 2016 #1. Hello Vets, I am service connected for my lower back and radiculopathy (lower right extremity). I am combined 30%, 20% for lower back and 10% for radiculopathy. I fell as a result of my lower back pain and a sciatic attack (radiculopathy) while walking. As a result of falling I tore up my right knee (torn ACL, …

Note: Complete paralysis (hand inclined to the ulnar side, index and middle fingers extended, atrophy of thenar eminence, cannot make fist, defective opposition of thumb, cannot flex distal phalanx of thumb; wrist flexion weak) Note: Complete paralysis (hand and fingers drop, wrist and fingers flexed; cannot extend hand at wrist, extend …Radiculopathy refers to the pinching of nerves in the spinal column. This pinching leads to symptoms including pain, numbness, tingling, or weakness radiating from the spine to other parts of the body. The VA provides a rating for veterans diagnosed with radiculopathy based on the nerves affected and the condition's severity.Entitlement to an increased disability rating for radiculopathy of the right lower extremity, evaluated as 10 percent disabling prior to July 31, 2012, and as 40 percent disabling from July 31, 2012. ... that, since his surgery in August 2007, he still had some numbness and tingling in his feet. He also described sharp low back pain that ...Here is how the VA rates for the common peroneal nerve (Diagnostic Code 8521): 40% rating for peripheral neuropathy - Complete paralysis of the nerve. Complete loss of movement and feeling in the nerve that controls the foot. Difficulty lifting the front part of your foot, and cannot bend your foot upwards.The middle and upper back area is your thoracic spine andthe lower back area is your lumbar spine. VA Ratings for Spine. For VA disability purposes, the four regions listed below will be considered when it comes to your final VA rating for Radiculopathy. But first, lets explore how the VA looks at Radiculopathyin more detail.VA rates lumbosacral strains under 38 CFR § 4.71, Schedule of Ratings – Musculoskeletal System, Diagnostic Code 5237. Importantly, this diagnostic code follows the General Rating Formula for Diseases and Injuries of the Spine. The rating criteria is as follows: 100% – unfavorable ankylosis of the entire spine. 50% – unfavorable ankylosis ...The electrodiagnostic study’s goal is to confirm the presence of peripheral neuropathy and assess its pattern and severity. Electrodiagnostic (EDX) testing involves nerve conduction studies (NCS) and electromyography (EMG) testing. [19] Planning an electrodiagnostic study is based on careful history taking and physical examination.What is cervical radiculopathy? Cervical radiculopathy results from a pinched or damaged nerve in the cervical region of the spinal column, located in the upper back and neck.This can lead to pain in the neck, shoulders, upper back, or arms. Most cervical radiculopathies occur in people between the ages of 30 and 60 and generally affect the lowest cervical vertebrae, which are labeled C5 to C7.Radiculopathy is a condition that occurs when the nerves in the spinal cord are damaged, irritated, or compressed. The typical symptoms of a radicular condition depend on the location of the affected …

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VA disability ratings are expressed as percentages and range from 10% to 100%. The disability rating for radiculopathy can range from 10% for minor radiculopathy affecting the hand to 90% for major paralysis affecting all three radicular groups (cervical, thoracic, and lumbar). There is not a 100% rating for radiculopathy alone, but 100% ...Yale Medicine orthopaedic surgeons are also continually honing their skills by performing a high volume of challenging surgical procedures, says Dr. Whang. Showing 4 of 10. Cervical radiculopathy occurs when a nerve in the neck becomes irritated, resulting in pain, numbness and/or weakness in the shoulders and arms.Lumbosacral radiculopathy is a condition in which a disease process affects the function of one or more lumbosacral nerve roots. The clinical aspects of lumbosa ... The lumbar spine consists of five movable lumbar vertebral bodies, numbered L1 to L5 . The sacrum is made up of five developmentally fused vertebral levels (S1 to S5), …Sometimes radiculopathy symptoms improve without the need for treatment. Traumatic brain injury: Treatment for traumatic brain injuries depends on the severity of the injury. If your injury is mild to moderate, you may require minimal treatment — perhaps a few weeks or months of abstaining from sports, work, school, and other taxing ...Lumbar spine radiculopathy can also result in a condition known as foot drop, which is rated from 10 to 40%. ... The DBQ for back and thoracolumbar spine conditions includes questions about your current diagnosis, your strength, reflexes, range of motion in the back, and your medical history. ...When surgery is necessary for radiculopathy, Och Spine at NewYork-Presbyterian/Weill Cornell Medical Center takes the least invasive approach possible. The goal of the surgery is to relieve nerve compression, thus relieving pain and restoring full use and motion of the affected limbs. Our spine surgeons have developed expertise in some of the most …Aug 4, 2023 · Low back pain is one of the most common musculoskeletal complaints encountered in clinical practice. It is the leading cause of disability in the developed world and accounts for billions of dollars in healthcare costs annually. Although epidemiological studies vary, the incidence of low back pain is estimated to be anywhere between 5% to more than 30%, with a lifetime prevalence of 60% to 90% ... Cervical radiculopathy (also known as “ pinched nerve ”) is a condition that results in neurological dysfunction caused by compression and inflammation of any of the nerve roots of your cervical spine (neck). Neurological dysfunction can include radiating pain, muscle weakness and/or numbness. “Cervical” comes from the Latin word ...The VA does not have a specific disability rating code for peripheral neuropathy. Instead, multiple rating codes are available depending on the nerve(s) impacted and the severity of your condition. However, the VA rates neuropathy analogously to several conditions listed under 38 CFR § 4.124a – neurological conditions and …Aug 3, 2023 ... Back pain and spinal problems are the most frequent Social Security Disability claim. Here's how you can successfully collect SSDI benefits ... ….

Recommendations for Diagnosis and Treatment of Lumbosacral Radicular Pain: A Systematic Review of Clinical Practice Guidelines. by. Ahmad Khoshal Khorami. 1, Crystian B. Oliveira. 2,3, …Degenerative Disc Disease is one of the most common causes of low back (lumbar), mid back (thoracic), and neck pain (cervical) in veterans. In more severe cases, Degenerative Disc Disease can cause weakness, numbness, and shooting or throbbing pain in the arms or legs, which is a painful condition known as Radiculopathy.VA Disability Ratings for Spinal Stenosis. The VA disability rating system for spinal stenosis is the same general formula as for other similar spinal conditions, including: Lumbosacral or cervical strain (diagnostic code 5237) - used to refer to neck or back pain, Spondylolisthesis/segmental instability (diagnostic code 5239) refers to a condition that causes vertebrae to slip forward over ...Practice Essentials. Some of the major causes of acute and chronic low back pain (LBP) are associated with radiculopathy. However, radiculopathy is not a cause …Jan 12, 2023 · Sciatica refers to pain involving a problem with the sciatic nerve. The Sciatic nerve is the largest nerve in the human body and extends from the lower back through the hips and the buttocks, down each leg. In most cases, sciatica can be caused by a ruptured intervertebral disk, an injury or narrowing of the spinal canal that puts pressure on ... When the limitation is not severe enough, the VA rates degenerative disc disease at either a 10% or 20% rating, using diagnostic code 5003 . A 10% rating is given when X-ray evidence shows symptoms of degenerative disc disease in two or more major joints or two or more minor joint groups. A 20% rating is granted when X-ray evidence …If you’ve heard of spinal decompression, you may be hopeful that this nonsurgical option will help your pain and discomfort. Learn about what it is and how much it costs in order t...VA Ratings for Cervical Spine Injuries. 40% Rating: Your neck is stuck in an uncomfortable, fixed position. Combined with a similar condition in your back, this could justify a full 100% disability rating. 30% Rating: While your neck might be fixed, it's in a less restrictive position, or you might manage a slight forward tilt. Lumbar radiculopathy dbq, INTRODUCTION. Lumbosacral radiculopathy is a condition in which a disease process impairs the function of one or more lumbosacral nerve roots and often leads to pain, numbness, and weakness in the back, groin, or leg. The most common causes of lumbosacral radiculopathy are compressive intervertebral disc herniation and degenerative spondylosis., Acute, Subacute, or Chronic Diseases. Rating. 5000 Osteomyelitis, acute, subacute, or chronic: Of the pelvis, vertebrae, or extending into major joints, or with multiple localization or with long history of intractability and debility, anemia, amyloid liver changes, or other continuous constitutional symptoms. 100., Lumbar radiculopathy is commonly caused by compression of a lumbar nerve root, resulting in symptoms which radiate down the legs. Symptoms include altered sensation, decreased reflexes, weakness, and pain, which may be described as sharp, shocks, burning, tingling, etc. Lumbar radiculopathy affects approximately 3-5% of the population., Apr 28, 2022 · As we discussed earlier, radiculopathy is a common neurological disability stemming from back or neck injuries. The VA also requires that bowel and bladder incontinence and impairment receive a separate rating. DBQ for thoracolumbar spine conditions , Mild symptoms are rated 10%. Code 8720: Neuralgia of the sciatic nerve (“sciatica”). Neuralgia cannot be rated higher than moderate, even if it is considered severe. If the condition is moderate, it is rated 20%. If it is mild, it is rated 10%., iamu. Lumbar strain with radiculopathy... As one rating. C&P Exams. Had my c&p a few days ago, and my original service connection (20 yrs ago) was for Lumbar strain with sciatic radiculopathy at 10%. I put in for an increase and thought it should be all separate. Ankylosis, sciatica both L/R and then other back issues., Radiculopathy is a condition that occurs when the nerves in the spinal cord are damaged, irritated, or compressed. The typical symptoms of a radicular condition depend on the location of the affected nerves. Common symptoms include: Numbness radiating from the spinal area. Physical weakness or pain., Radiculopathy is a neurological condition, separate from your back. It will be rated on its own apart from your back. ... But future increases directly for those nerves, comes off of the appropriate nerves DBQ? I didn't claim radiculopathy, but in my recent supplemental c&p exam (for lumbar issues) the examiner put down two nerves in my left ..., Jun 29, 2013 · My DBQ results for radiculopathy were as follows: Does the Veteran have Radicular Pain: Yes. Intermittant Pain - Right lower - mild. left lower - mild. parasthesias - right lower - mild. left lower - mild. Numbness - right lower - mild. left lower - mild. Indicate severity of radiculopathy and side affected. , Apr 8, 2021 ... VA Disability Claims That Will Get You A 30% VA Rating Or H... Jan 8, 2023 · 1.8K views. 12:46. The Ultimate Guide to 2023 VA, Effects from neuralgia are considered moderate at worst by VA standards. The condition uses these sciatica VA rating guidelines: 20%: Moderate symptoms. 10%: Mild symptoms. Diagnostic code 8520, or paralysis of the sciatic nerve, has more extensive rating rules, including: 80%: Complete paralysis as evidenced by the foot dangling and …, Finally, in the absence of limitation of motion, a veteran's degenerative disc disease VA rating will be as follows: 10% - with X-ray evidence of involvement of two or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations. 20% - with X-ray evidence of involvement of two or more major joints or ..., 16. Jun 04, 2016 #1. Hello Vets, I am service connected for my lower back and radiculopathy (lower right extremity). I am combined 30%, 20% for lower back and 10% for radiculopathy. I fell as a result of my lower back pain and a sciatic attack (radiculopathy) while walking. As a result of falling I tore up my right knee (torn ACL, torn MCL, and ..., The AMC rated the Veteran's degenerative joint disease of the low back as 40 percent disabling. Separate ratings were assigned for his radiculopathy of the right extremity as 30 percent disabling, and his radiculopathy of the left extremity as 30 percent disabling. ... The nerve involved in lumbar radiculopathy is the sciatic nerve. Neuritis of ..., Everything you need to know to win your back and/or neck claim. This video features a conversation with attorney Shana Dunn a Founding Partner at the law fi..., The examiner did the full lower back DBQ. Additionally, she asked me very specific questions about my symptoms with the radiculopathy. As a side note, she gave me a 60 degree forward range of motion on the DBQ, while I can assure you I barely made 20 degrees when she asked me to lean forward. Bogus. However, I did get a 20% rating for ... , The Department of Veterans Affairs encourages all Veterans to submit their private medical records for consideration during the processing of their benefits claim. VA values evidence from your private treatment providers because they are familiar with your medical history, often over a long period of time. VA appreciates the trusted and special ..., We review the epidemiology, etiology, symptomatology, clinical presentation, anatomy, pathophysiology, workup, diagnosis, non-surgical and surgical management, …, The primary cause of sciatica (present in about 90 percent of cases) is spinal disc herniation pressing on one of the lumbar or sacral nerve roots. Sciatica itself actually refers to a symptom rather than a specific disease. The symptom is likely caused by a lumbar or sacral radiculopathy secondary to degenerative disc disease. Symptoms, Currently, VA rates neck pain severity on the following values: 0% rating — Forward flexion of the cervical spine over 40 degrees. 10 % rating — Forward flexion of the cervical spine over 30 degrees, but less than or equal to 40 degrees; or a combined range of motion of the cervical spine above 170 degrees but not causing abnormal spine ..., Understanding Radiculopathy. Radiculopathy is a back condition that can occur when the bones in your back lose the cushioning between them and rub together, sometimes pinching a nerve. When this happens, the pinched nerve may cause numbness, weakness, pain, and/or tingling. These symptoms can be felt in the cervical area (upper spine), the ..., Lumbar radiculopathy is irritation or inflammation of a nerve root in the low back. It causes symptoms that spread out from the back down one or both legs. To understand …, Diagnosis of lumbar radiculopathy is particularly challenging due to the anatomy involved. In the lumbar spine, the dorsal and ventral lumbar roots exit the spinal cord at the T11-L1 bony lev-el and travel in the lumbar canal as a group of nerve roots in the dural sac known as the ‘horse’s tail’ or cauda equina. Multiple, A 60 percent disability rating for paralysis of the sciatic nerve is possible for those with severe damage and visible muscular atrophy below the knee. A 40 percent rating is available for those with moderately severe damage. Moderate cases qualify for 20 percent disability, while mild cases may meet the requirements for 10 percent disability., The spine is divided into three sections: cervical (upper back), thoracic (mid back), and lumbar (lower back). Likewise, there are three types of radiculopathy, each named for the section of the spine where the damaged nerves are located – cervical radiculopathy, thoracic radiculopathy, and lumbar radiculopathy.. Symptoms vary …, Disability Benefits Questionnaires (DBQs) are forms that guide a physician during an exam to ensure that all the information needed to correctly rate a disabled veteran’s conditions is properly recorded. The VA released new Public Disability Benefits Questionnaires (DBQs) in March 2021. Before this date, DBQs were intended mainly for use by ..., Home | ND Department of Veterans Affairs, If you’ve heard of spinal decompression, you may be hopeful that this nonsurgical option will help your pain and discomfort. Learn about what it is and how much it costs in order t..., The VA rating for cervical radiculopathy is determined based on symptoms in the shoulder, arm, and hand. If a veteran can prove that their service-connected spinal condition was the primary cause of the secondary condition, they may qualify as having a secondary service-connection condition., cion of lumbar radiculopathy. Clinical neurological examination tests could be used to discriminate patients with radiculopathy distinct from other low back pain sub-types like non-specific low back pain of somatic ori-gin, lumbar facet or intervetebral joint derangement dis-order. These tests are easy to perform, cost-effective and, M54.10 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM M54.10 became effective on October 1, 2023. This is the American ICD-10-CM version of M54.10 - other international versions of ICD-10 M54.10 may differ., The diagnosis was lumbar degenerative disk disease with moderate right lower extremity S1 radiculopathy. In June 2004, another VA Compensation and Pension examination of the veteran was conducted. This time the veteran reported having bilateral lower extremity radiculopathy with the symptoms of pain being greater on the right than the left., Flat feet often can cause a substantial change in your walking gait, causing an abnormal strain on the musculoskeletal system. This can lead to the development of a number of possible secondary conditions linked to flat feet. Some of the more common conditions are: Degenerative Disc Disease. Because of the change of walking gait, often spinal ...