QUESTION: I need guidance on how to use the Guides, Fifth Edition to rate a patient with a spinal fusion that involves both the thoracic and lumbar regions. She is a 49-year-old woman who 4 years ago sustained a severe flexion injury to her thoracolumbar region; she was changing a flat tire, the car fell off the jack and she was pinned under the car. She sustained an unstable fracture of T-12 with retropulsion of bone and angular deformity. There was no spinal cord involvement. Two days later she underwent a posterior reduction of the T12 burst fracture, limited bilateral laminectomies at T-11 and T-12 and posterior segmental spine instrumentation and fusion from T9 to L2. She has discomfort in her lower lumbar spine with some interference in activities of daily living (ADLs). Physical examination reveals moderate motion...
