Kinsman's Case Summary

MRI of the lumbar spine performed on 10/30/14 demonstrated mild anterolisthesis and prominent degenerative changes at L4-5, resulting in contact and possible impingement upon passing L5 nerve roots bilaterally. There is moderate bilateral facet arthropathy at this level. Mild central canal narrowing is seen at L4-5. Mild chronic compression deformity, superior endplate of T12 is seen.

MRI of the cervical spine obtained on 06/26/13 showed mild degenerative spondylitic changes and status post posterior fusion.

As per medical report dated 4/19/16, a lumbar MRI with and without contrast was requested to evaluate for a discogenic and/or facetogenic etiology for pain. MRI would also allow evaluation of conditions such as spinal stenosis.

MRI demonstrates severe narrowing of the right fouramen due to severe collapse at L5-S1. EMG demonstrates positive radiculopaty. The claimant has severe back and right leg pain. The claimant has a positive EMG. The claimant has an MRI which demonstrates up and down stenosis in the foramen at L5-S1, compressing the L5 nerve root due to severe collapse of the L5-S1 disk. The claimant has elected to proceed forward with an anterior interbody fusion at L5-S1 with an anterior decomprssion and stabilization. The claimant has severe collapse of the L5-S1 disk resulting in foraminal stenosis. The provider states a posterior decompression alone would be inadeqate given the severe collapse of the disk and the up and down

Per the Agreed Medical Re-Examination report dated 09/29/15, whole person impairment rating is 5%. Future medical care includes access to follow-up visits for monitoring of his condition for the next calendar year, with continued provision of pharmacological agents. Should patient experience a significant acute symptoms flare-up within the next calendar year, re-instatement of brief courses of traditional PT, acupuncture,

MRI of the cervical spine dated 08/17/16 showed at C3-4 and C4-5, there is mild posterior disc bulging.

11/13/14 MRI of the lumbar spine showed 4mm left paracentral and foraminal disc protrusion at L4-5, which mildly impinges upon the thecal sac and the proximal left L5 nerve root. The disc protrusion also moderately narrows the left foramen and lateral recess. There was also a 2mm posterior central disc protrusion at L5-S1. A 2mm disc bulge at L2-3 was seen. There was a mild degenerative facet and ligament flava hypertrophy at L4-5 and

It was noted that the patient has made significant gains in the HELP functional restoration program attaining his goals. He is still unable to return to work but is determined to do so. He is certainly not regressed in any way. He continues in a positive direction in his home exercise program despite occasional flares. He has made some medication reductions since he has left the

DOI: 6/26/2002. The patient is a 64 -year-old female patrol officer who sustained a work-related injury to her back, shoulder and legs due to constant driving at work. As per OMNI, the patient is status post lumbar surgery on 1/13/11 and epidural steroid injection on 9/24/12. MRI of lumbar spine with and without contrast dated 6/6/12 revealed congenitally shortened pedicales at the L1-L2 level but no impingement on the thecal sac or nerve roots at this level is identified; desiccated L2-L3 disc with bilateral facet joint arthropathy resulting in moderate bilateral neural foraminal stenosis but no impingement on the thecal sac or nerve roots at this level is identified; desiccated L3-L4 disc with bilateral facet joint arthropathy resulting in moderate bilateral neural foraminal stenosis but no impingement on the thecal sac or nerve roots at this level is identified;

MRI of the lumbar spine dated 12/11/15 reveals disc desiccation with associated loss of disc height at L5-S1; posterior annular tear at L5-S1; hemangioma at L5; and L5-S1 focal right paracentral disc herniation which abuts the thecal sac. Disc measurement is 3.3 mm.

An MRI of the lumbar spine dated 03/23/17 revealed broad-based central 4 mm subligamentous disc protrusion and annular tear at L4-L5. There was a 2.7 mm subligamentous disc protrusion centrally at L5-S1. Neither of these two levels demonstrated compressive discopathy, central canal stenosis or foraminal impingement. There was a mild straightening of the normal lumbar

DOI: 6/28/2007. Patient is a 66 year old male ship-packer who developed pain from unloading stack of bread from trailer. Per OMNI, he underwent knee surgery on 5/28/2008, partial knee replacement on 4/12/2010, and elbow surgery on 5/08/2013.

MRI of the lumbar spine without contrast dated 5/23/11 revealed L4-5 status post anterior lumbar fusion, left posterior lumbar fusion and left L4 hemilaminotomy. The anterior fusion plug projects into the central/left ventral epidural space by 2mm. Granulation tissue is present within the laminotomy defect

Based on the progress report dated 04/05/16 by Dr. Fieser, the patient complains of pain in the left knee, left ankle and left foot, associated with numbness and tingling in the left leg/foot, as well as weakness in the left leg. He describes the pain as sharp, cutting, throbbing, dull, aching, pressure-like, cramping, shooting and shocking with muscle pain and pins-and-needles sensation.

DOI: 5/15/1996. Patient is a 58-year-old male ice delivery man who sustained a work-related injury to his back while unloading ice cream from a freezer. As per OMNI entry, the patient has future medical care to include primary treating physician visits; epidural steroid injection; possible lumbar fusion; and medications, such as hydrocodone, acetaminophen, and carisoprodol.