367The adjusted WPI assessment may not exceed the maximum WPI rating available in each individual table.

367     The adjusted WPI assessment may not exceed the maximum WPI rating available in each individual table.

9.15   Cervical spine – diagnosis-related estimates

Table 9.15: Cervical spine – diagnosis-related estimates

See note to Table 9.15 for further information.

| 0 | No significant clinical findings, no muscular guarding, no documented neurological impairment, no significant loss of motion segment integrity, no other indication of impairment related to injury.<br>or<br>No fractures. | | 8 | Clinical history and examination findings compatible with specific injury. Findings may include: muscle guarding or spasm; asymmetric loss of range of motion or non-verifiable radicular complaints defined as complaints of radicular pain without objective findings.<br>and<br>No alteration of structural integrity.<br>or<br>Clinically significant radiculopathy and objectively demonstrated disc herniation consistent with the radiculopathy (improved following non-operative treatment).<br>or<br>Fractures:<br>Compression fracture of one vertebral body of less than 25%; orPosterior element fracture without dislocation – healed without loss of structural integrity or radiculopathy; orSpinous or transverse process fracture with displacement. | | 10–18 | Significant signs of radiculopathy, such as pain and/or sensory loss in a dermatomal distribution, loss or alteration of relevant reflex(es), loss of muscle strength, or unilateral atrophy compared with the unaffected side, measured at the same distance above or below the elbow. The neurological impairment may be verified by electrodiagnostic findings.<br>or<br>Clinically significant radiculopathy and objectively verified disc herniation consistent with the radiculopathy, or with improved radiculopathy following surgery.<br>or<br>Fractures:<br>Compression fracture of one vertebral body of 25% to 50% – healed without loss of structural integrity, with or without radiculopathy; orPosterior element fracture with displacement disrupting the spinal canal – healed without loss of structural integrity, with or without radiculopathy.<br>Note: In the case of fractures, differentiation from a congenital or developmental condition should be accomplished, if possible, by examining pre-injury roentgenograms, if available, or by a bone scan performed after the onset of the condition. | | 28 | Alteration of motion segment integrity (at least 3.5mm of translation of one vertebra on another or angular motion of more than 11° greater than at each adjacent level).<br>or<br>Bilateral or multilevel radiculopathy with objectively verified disc herniation consistent with the radiculopathy.<br>or<br>Loss of motion of a motion segment due to a developmental fusion or successful or unsuccessful attempt at surgical arthrodesis.<br>or<br>Compression fracture of one vertebral body of more than 50% without residual neural compromise. | | 38 | Significant upper extremity impairment requiring the use of upper extremity external functional or adaptive device(s). There may be total neurological loss at a single level or severe, multilevel neurological dysfunction.<br>or<br>Structural compromise of the spinal canal with severe upper extremity motor and sensory deficits but without lower extremity involvement. |