Lmbar Bulging Case Summary

DOI: 9/4/2014. The patient is a 51-year old male paint maker who sustained a work-related injury when he missed a step on a platform and fell, jarring his back. As per OMNI entry, he was diagnosed with lumbar sprain and lumbosacral disc degeneration.

Moreover, now I learn most specific radiological techniques for different condition especially associated to spine. I learn importance of MRI and CT scan in different spinal pathological condition. To improved knowledge regarding types of MRI or CT scan method will most appropriate to condition, for instance, in the disc herniation condition, MRI will provide most appropriate result for soft tissue injury but in other cases CT myelogram is second choice techniques. Discography, is second last choice, before spinal surgery or fusion. I used to seen a 57 year old male patient with lower back pain, patient have improvement in pain with modality and strengthening exercises techniques but suddenly one day he was lifting trash pot and feel severe pain with radiating symptoms and feeling less sensation around inner thigh. Next day he came to me and complaining of this symptoms which are indicates for referral and further investigation. Afterwards, MRI reports revealed prolapsed intervertebral disc (PIVD-extrusion) at level lumbar 3 and 4 (L3-L4). I also learn certain condition (spinal stenosis), physical examination will helpful to detect pathological condition and which always should be confirmed by diagnostic imaging method and requirement for referral to appropriate

As of this report, an MRI done on 03/14/16 showed multilevel lumbar spondylosis. No significant central canal stenosis was noted. There were few areas of neural foraminal stenosis secondary to disc bulging and mainly bilateral facet

MRI of the lumbar spine obtained on 07/15/08 showed post-surgical changes at L4-5 and L5-S1, multilevel degenerative changes, most prominent at L4-5 and L5-S1, and foraminal narrowing at L4-5 and L5-S1.

DOI: 1/29/2012. Patient is a 34-year-old female clinical assistant who sustained a work-related injury to her back when she was transferring a patient and felt pain in her low back and left side. She has prior history of lumbar laminectomy. She was treated conservatively with non-steroidal anti-inflammatory drugs, physical therapy and work restrictions. Per the PT progress notes dated 10/29/14, patient has attended 21 sessions for the back. She is status post left sacroiliac joint and left piriformis trigger point injection on 08/27/15.

On examination of the lumbar spine, there is moderate to severe muscle spasm and tenderness of the paraspinal muscles and spinous process at L4-5. There was painful active

MRI of the lumbar spine without contrast dated 8/24/15 revealed a broad-based bulge (4mm) at L4-5, which in conjunction with facet hypertrophy and ligament flava laxity, produces mild central canal narrowing and moderate-severe bilateral neural foraminal narrowing. There is a posterior superimposed central annular fissure (7mm). At L5-S1, there is a broad-based bulge (5mm) which in conjunction with facet hypertrophy and ligament flava laxity,

MRI of the lumbar spine dated 07/24/15 showed degenerated L4-L5 disc. There is a significant foraminal narrowing at L4-L5 on the left with effacement of the left L4 nerve root.

DOI: 12/09/2000. This is a 58-year-old male sanitary engineer who sustained an injury to the low back when he fell while stepping down a ladder. Patient is diagnosed with other intervertebral disc degeneration, lumbar region. He is status post lumbar spine surgery on 05/19/2006. Per medical report dated 5/26/16, the patient complains of lower back pain which has increased since his last visit, rated as 9/10 without medication. His quality of sleep is poor and activity level remains the same. As per office notes dated 6/26/16, the patient rates his pain as 9 with medications and 10 if without medication. He states that the medication is working well and no side effects noted. CURES (Controlled Substance Utilization Review and Evaluation System)

MRI of the cervical spine without gadolinium dated 04/09/2015 showed severe 5mm left lateral recess focal disc protrusion with moderate canal stenosis and flattening of the left ventral cord and mild to moderate left neuroforaminal stenosis at C4-5. At 3-4, there was a moderate 4mm foraminal

On 12/19/2017, the claimant presented with lumbar pain. She had continued constant nagging pain with radicular pain in the left lower extremity. She had weakness and numbness. In 2012, she underwent L4-S1 fusion. She had lumbar medial branch block in 04/2017, which helped with the axial low back pain by more than 50%, but the radicular pain becomes severe. She stated that the previous bilateral L5 and left S1 selective nerve root block on 06/21/2017 provided 100% pain relief for 3 days before the pain gradually returned. She also had epidural steroid injection and trigger point injection, which did not help with the pain. The alleviating factors include medication, rest, heat, and TENS unit. The previous physical therapy and chiropractic care had helped significantly. Objective findings showed positive straight leg raise test on the left with tenderness in the left lower lumbar area and bilateral

DOI: 9/11/2001. Patient is a 47-year-old female correspondence reader who sustained a work-related injury while evacuating when she was pushed and fell in chaos due to an event. Per OMNI, she was diagnosed with herniated lumbar disc. It was noted that the patient has had

DOI: 7/16/2002. The patient is a 61-year old male assistant store manager who sustained a work-related injury to his low back when he lifted a bucket of pain. As per OMNI entry, the patient was diagnosed with multi-level degenerative disc disease of the lumbar spine. As per medical report dated 6/13/16, the patient rates his pain with medications as 5 and 8 if without medications. Quality of sleep is fair. Activity level has remained the same. The patient is diagnosed with postlaminectomy syndrome, not elsewhere classified; spondylosis without myelopathy or radiculopathy lumbosacral region; other spondylosis with myelopathy, cervical region; other spondylosis with myelopathy, cervicothoracic region; and other spondylosis with myelopathy, site

On the other hand, in patients with the disc attrition and lumbar spine disease lumber foramina stenosis holes cause conflicts in nerve roots which it will be known by the pain in the legs (1). About MRI imaging routine methods from lumbar spine and its sequences which includes T1 and T2 sagittal images and T2 axial and in some cases gradient echo imaging (G.E). routine MRI imaging method for the expression of pressure on the nerves and nerve roots and to determine stenosis area and its extend (1) and stating the real cause of the pain does not seem complete sometimes. In previous years we have tried new methods for better and more complete investigation on the spinal canal and vertebral discs (17). In diffusion method, lumbar discs will be known in discs by having its damage in Annulus Fibrosus also decrease in cartilage content by diffusion reduction of contrast drug (paranormal diffusion). Also early changes of erosion with this method is being observed faster than routine method

A 28 year old female presented to our institution with a three-month history of right sciatic pain in the S1 distribution. She was initially treated conservatively with analgesia and physiotherapy, however her pain continued despite these interventions. She had no weakness or bowel or bladder symptoms. On examination she had a positive Lasegue?s test at 30 degrees on the right. No motor of sensory deficits were found. A lumbar Magnetic Resonance Image (MRI) scan done showed a paracentral disc bulge at L5/S1 impacting the traversing right S1 nerve root, and exit foraminal stenosis (Fig 1). She was taken to the