BRIEF HISTORY: This 40-year-old Latin female was admitted for low back and right lower extremity symptoms. She had been suffering from intermittent low back pain dating back to an MVA several years ago. In December of last year she started a job where she was doing a lot of heavy lifting. Shortly after that she began experiencing pain in her back and right leg. CT scan was done that showed questionable disk bulging. This was followed by a myelogram that showed no definite defect. However, repeat CT showed marked compression at the L4-5 level. Some ligamentum flavum prominence and low-grade disk bulging. On May 27, the patient underwent a lumbar diskectomy at L5-S1 on the right side and a disk herniation was identified at the time of surgery. Postoperatively the patient had resolution of her low back pain and right leg symptoms and was doing reasonably well at the time of discharge. She remained afebrile throughout her hospital course. Her incision was healing nicely and she was ambulating without difficulty.…
HISOTRY OF PRESENT ILLNESS: This 40-year-old Latin female presents with complaints of low back and right leg pain she said that she hurt her back in a motor vehicle accident three years ago and she has had a history of intermittent low back pain since that time. Last December she started a job where she had to lift boxes that weighed approximately 40 pounds. Around the first of January this year she began to complain of back pain that gradually went into her right leg the pain is primarily in the sacral iliac region and radiates into the buttock and lateral lower leg as far as the ankle. She has no numbness, coughing and sneezing exacerbates her pain. She has to move around to get comfortable when lying down, but she is more comfortable lying down than in any other position. She’s still working fulltime but is not doing the heavy lifting at this time. She has been going to a Chiropractor for the last two months with no pain relief. She’s taken Flexeril, Norflex, Tylenol with codeine and Darvocet, all of these have failed to improve her symptoms. She had a CT scan done recently and we are getting those results.…
DOI: 2/13/2004. The patient is a 66-year-old male bartender/food server who sustained a work-related injury when he slipped and fell as he was walking through the dish area.…
DOI: 7/28/2000. The patient is a 46 -year-old female professor who sustained a work-related injury after being rear-ended while waiting for a pedestrian to cross the street against a green light. As per OMNI, the patient is diagnosed with chronic low back strain and chronic occipitocervical dysfunction.…
38. What 2 muscles, if tight, create a false positive on the standing flexion test?…
DOI: 1/11/2010. Patient is a 67-year-old male folder who sustained injury while he was pulling out towels out of a hopper. Per OMNI entry, he was initially diagnosed with neck and upper back strain. It was noted that the IW continues with chiropractic care.…
Diane Fenchel is a chiropractic physical therapist at Anchor Bay Spine Center in New Baltimore, Michigan. She has a second job for which she is the manager of the physical therapy department in a medical care facility. She spoke unfavorably of her second job, however. Diane said she does not like the system in place there, “it’s disorganized and has a lot of obstacles everyone has to push through, plus I don’t like the traditional medical field anyway.” Unfortunately Diane’s position does not entail the restructuring of systematic procedures for greater efficiency. Diane would not choose this managerial profession again. But what keeps Diane going is her passion for helping people & relating with them.…
DOI: 8/15/2013. Patient is a 58-year-old female cleaner who sustained injury while she was cleaning and mopping the bathroom when she fell and hit her head/back. Per OMNI, she was diagnosed with cervical and lumbar radiculopathy, cervical herniations at C5-7, and lumbar herniation at L3-4. She underwent an anterior cervical diskectomy and fusion at C5-6 and C6-7 on 04/03/14 and lumbar laminectomy at L4-5 on 09/10/15.…
Famous film director and entrepreneur George Lucas once said, “technology keeps moving forward, which makes it easier for the artists to tell their stories and paint the pictures they want”. Robin Sloan, author of Mr. Penumbra’s 24-Hour Bookstore, contradicts Lucas’s opinion by organizing a plot that involves a secret “bibliophile cult” (113), the Unbroken Spine, and their quest to solve the Founder’s Puzzle. Aldus Manutius, the founder of the Unbroken Spine, composed the Codex Vitae without the use of technology, but with the help of Griffo Gerritszoon and his handmade typeface. When decoded, the Codex Vitae will hold the key to eternal life for all members of the Unbroken Spine. When Clay Jannon gets a job at Penumbra’s bookstore, he is intrigued…
Per office visit note dated 11/20/2015, patient complained of neck pain. His medications are Advil 200mg, Norco 5/325mg, and Flexeril 10mg. He has been treated with cervical interlaminar epidural steroid injection, which helped him immensely with the radicular symptoms. He has failed pain medication, physical therapy, rest, home exercise program, and even surgery.…
Abstract: Posterior Lumbar spinal instrumentation has become an integral part of the management of various spinal pathologies including degenerative disc diseases, vertebral fracture, deformity, and tumor. The rate of infection greatly varies from 2% to 20% of all instrumented spinal cases. Any occurrence in the setting of infection can affect the patients’ long-term outcomes and increase patient morbidity, health care costs and greater dissatisfaction with the initial operative procedure. Despite the development of prophylactic antibiotics, continued advances in surgical techniques and postoperative care, surgical site infections(SSI) still remains a challenging and costly complication after spinal surgery. This review analyses the preventative…
Mr. Baird replied, he has pain to his lumbar back with pain radiating into his right leg. The pain awakens him from sleep Mr. Baird usually obtains 4 hours of sleep and is up at 6:00 am. Mr. Baird rates his lumbar discomfort a “9” on the 1-10 pain scale. Mr. Baird described his foot being numb and tingling sensations. The discomfort can be stabbing. He had two epidural injections at Beaumont Hospital Pain Management but had not received the third injection until recently on August 4, 2017. Mr. Baird felt the first two had provided some relief but not complete pain removal. He does wear a back support brace. I inquired about how many hours he uses his brace for and he replied, all the time. I suggested he remove the brace when he is sitting or lying down. I inquired about the recent falls he had experienced and the location of the falls. Mr. Baird replied he was outside walking to the corner (He has a corner lot) and his leg gave out. When this occurred he fell, even when he used his…
According to the Institute of Medicine of The National Academies, the number of Americans who suffer from chronic back pain is 100 million (AAPM). Fortunately, there are many options out there that may help these Americans with their back pain. Relief ranges from surgeries to injections and from chiropractors to physical therapists and all in between. Having been diagnosed with scoliosis and degenerative disk disease since 2006, I have personal experience with most all of these treatments. Anyone suffering from grave pain of the spine needs to understand the difference between physical and chiropractic therapy before deciding which one to select as the correct therapy to relieve his or her pain. Although chiropractic work therapy and physical therapy both seem to be effective in treating diseases of the back, physical therapy seems to be more effective.…
There are all kinds of injuries and diseases of the spine that can warrant having a surgical procedure done. There are also many non-surgical options for those who are not experiencing dramatic issues. There are times when an injury or disease lies right in between, and often two different doctors will have differing opinions regarding the best course of action.…
Address reprint requests to J.M.A. Mens Spine & Joint Centre Westerlaan 10 3016 CK Rotterdam, The Netherlands E-mail: sjceco@wxs.nl…