Military Medical Standards: Spine and Sacroiliac Joints
Spine and Sacroiliac Joints
When a recruit goes to MEPS (Military Entrance Processing Station), he/she will be thoroughly tested and evaluated medically as well as take the ASVAB. Prior to this meeting with military doctors, whose sole job is to see if recruits have any medical issues that will prevent them from military service, the recruiter will pre-approve candidates after the recruit fills out medical questionnaires. Many times, recruits will need waivers due to medical procedures, surgeries, injuries, illnesses, and any congenital defects. Many of these will disqualify a recruit from joining the military, however depending upon the severity of the issue, waivers may be offered to recruits on a case by case basis. The following is a list of spinal and hip defects, injuries, and histories that may be disqualifying from military service:
Disqualifying Medical Conditions of the Spine
Current or history of ankylosing spondylitis or other inflammatory spondylopathies is disqualifying.
Ankylosing Spondylitis or AS, is a form of arthritis that typically affects the spine, but other joints can suffer from similar inflammation, pain, and discomfort. In more advanced cases, inflammation can lead to fusing of the vertebrae, called ankylosis. This is basically bone formation in the spine that causes immobility between the joints – also known of spinal fusing. Inflammatory Spondylopathies are other diseases of the vertebrae or spinal column.
General Spinal and Hip Pain and Weakness
Current or history of any condition, including, but not limited to the spine or sacroiliac joints, with or without objective signs that:
- Prevents the individual from successfully following a physically active vocation in civilian life or that is associated with local or referred pain to the extremities, muscular spasm, postural deformities, or limitation of motion is disqualifying.
- Requires external support or braces is disqualifying.
- Requires limitation of physical activity or frequent treatment is disqualifying
- History of congenital fusion, involving more than two vertebral bodies is disqualifying.
- Any surgical fusion of spinal vertebrae is disqualifying.
Types of Spinal Curvatures
The spine has three types of curves: lordotic, kyphotic (the outward curve of the thoracic region), and scoliotic (sideways curving). A small degree of both kyphotic and lordotic curvature is normal.
Lumbar Scoliosis is a side-to-side curve in the spine in the lumbar region (L1 through L5). Degenerative scoliosis is a result of wear and tear on the discs and joints of the spine. It is the most common type of scoliosis in adults, and usually happens in the lumbar (lower) spine.
Thoracic scoliosis – Though more rare than Lumbar Scoliosis, Thoracic scoliosis is a curvature of the spine within the mid-back or thoracic region (rib care area).
Current deviation or curvature of spine from normal alignment, structure, or function is disqualifying if:
- The Scoliosis prevents the individual from following a physically active vocation or sports in civilian life.
- It interferes with the proper wearing of a uniform or military equipment.
- It is symptomatic.
- There is lumbar scoliosis greater than 20 degrees, thoracic scoliosis greater than 30 degrees, or kyphosis and lordosis greater than 55 degrees when measured by the Cobb method is disqualifying for military service.
Kyphosis is a deformity of the vertebrae in the upper back. This bone thinning disorder can be caused by a variety of issues but can results in crushed vertebrae (compression fractures).
Lordosis is an increased inward curving of the lumbar spine (just above the buttocks).
Spinal Fractures, Herniations, or Dislocations
Current or history of fractures or dislocation of the vertebrae is disqualifying. A compression fracture, involving less than 25 percent of a single vertebra is not disqualifying if the injury occurred more than 1 year before examination and the applicant is asymptomatic. A history of fractures of the transverse or spinous processes is not disqualifying if the applicant is asymptomatic.
History of juvenile epiphysitis with any degree of residual change indicated by x-ray or kyphosis is disqualifying.
Current herniated nucleus pulposus (disks) or history of surgery to correct this condition is disqualifying.
The most frequent cause of a herniated “disk” is age-related degeneration that develops over time as the spine bears the strain and stress of everyday life. Certain factors, however, may encourage or exacerbate a herniated disk, such as:
- Excess weight or obesity, lack of exercise, sudden lifting or compression injuries, such as those that may occur during a motor vehicle accident, fall or high-impact sport, even smoking, excessive alcohol consumption and genetics.
Current or history of spina bifida when symptomatic, if there is more than one vertebra level involved or with dimpling of the overlying skin is disqualifying. History of surgical repair of spina bifida is disqualifying.
Spina bifida is a birth defect that occurs when the spine and spinal cord don't form properly.
Current or history of spondylolysis (congenital or acquired and spondylolisthesis (congenital or acquired) are disqualifying.
Derived from Department of Defense (DOD) Directive 6130.3, "Physical Standards for Appointment, Enlistment, and Induction," and DOD Instruction 6130.4, "Criteria and Procedure Requirements for Physical Standards for Appointment, Enlistment, or Induction in the Armed Forces."