Lumbar Tissue: A Case Study

MRI of the lumbar spine obtained on 05/19/15 revealed at L2-3, endplate osteophyte formation and disc bulge contribute to a mild degree of spinal canal stenosis and a mild degree of bilateral neural foraminal compromise. At L3-4, a disc bulge eccentric leftward and endplate osteophytes formation are responsible for a mild degree of spinal canal stenosis, a mild degree of right neural foraminal encroachment, and a moderate degree of left neural foraminal encroachment. At L4-5, there is a diffuse disc bulge and endplate osteophyte formation which effaces the ventral aspects of the thecal sac and are responsible for a moderate-to-severe degree of spinal canal stenosis, a mild degree of right neural foraminal encroachment, and a severe degree of left neural foraminal encroachment. At L5-S1, a shallow disc bulge and endplate osteophyte formation contribute to a mild degree of left neural foraminal encroachment, without compromise of the spinal

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.

IAT is reporting they received an adverse verdict in the amount of $2,305,376 on 10/13/16, with likelihood the plaintiff will be awarded additional monetary damages based on jurisdictional laws.

DOI: 09/12/2014. Patient is a 45-year-old male vacation relief route sales representative who sustained a work-related injury to his lumbar spine from bending and pulling a bread product. Per OMNI entry, he was initially diagnosed with disc herniation at L4 to L5 with radiculopathy. He is status post extraforaminal L4 to L5 discectomy on 04/09/2015. He has been off work for nearly 2 years.

Per the medical report dated 03/29/2016 by Dr. Waghmarae, the patient believes that her left buttock pain has increased over the last month. She describes her pain as aching, throbbing and stabbing. She rates her pain symptoms as 8/10. Pain is relieved by medication, heat, ice and use of a Transcutaneous Electrical Nerve Stimulator (TENS) unit, and is increased by movement and standing for long periods of time. She states that her bilateral legs have also increased in pain severity over the last month. She believes because she is doing a lot of standing and trying to clean up her house. She states that pain is increasing in her left buttock. She is not involved in physical therapy, chiropractic, massage therapy or acupuncture. Palpation of the lumbosacral spine reveals abnormalities along the bilateral facet joints. There is pain in her axial lower back in all planes of lumbar motion that is

DOI: 8/24/2008. Patient is a 55-year-old female manager who sustained injury to her neck and back when she slipped and fell while walking down a set of pull out stairs. Per OMNI, she is diagnosed with cervical strain with radiculopathy and lumbar radiculopathy. She underwent C5-6 partial corpectomy and fusion in 05/31/2011.

DOI: 06/23/2011. This is a case of 41-year-old male maintenance worker who sustained injury to the low back while taking off a sliding door of a patio. As per OMNI notes, patient is diagnosed with lumbar disc disorder with myelopathy. MRI of the lumbar spine dated 6/28/15 revealed recurrent left paramedian L4-5 disc herniation with caudal extrusion of a 10 mm fragment into the left L5 lateral recess. As per office notes dated 7/25/16, the patient is status post redo left L5-S1 discectomy performed on 4/20/16. It was also noted that the patient had a prior L5 laminotomy several years ago. He subsequently did well. However, he had recurrence of his pain. Pain is radiating into his left leg worse on the right leg. This was unresponsive to conservative

Per the medical report dated 08/12/16 by Dr. Gunderson, the patient had neck pain, as well as headaches, dizziness and blurred vision. The neck pain radiated into both shoulders, but more so on the right, and occasionally she had tingling in her upper extremities. She described the neck pain as severe and intermittent, and not related to any specific activity, and relieved with massage. The pain in her lower back was in the beltline and radiated into both lower extremities, more so on the left. She described the pain as moderately severe and constant, and not related to any activity, and only relieved with nerve medicines. On examination, the patient had tenderness in the lower cervical region about C5 to C7. Range of motion of her neck was 75% of normal. Motor, sensory, and reflex examinations in the upper extremities were normal. On examination of the lumbar spine, the patient could dress and undress without difficulty. She had a bent forward posture and gait. She had reduced lumbar motion and with maximum forward flexion, her fingertips were 12 inches from the floor. Lateral flexion was 50% of normal, and she had no active extension in the lumbar spine. Motor, sensory, and reflex examinations in the lower extremities were normal. There was paravertebral tenderness about L4-5 bilaterally, as well as in both sacroiliac and sciatic notch regions. Straight leg caused hip and thigh pain at 50 degrees bilaterally. Of note, X-rays of the cervical spine demonstrated disc degeneration at C5-6. X-rays of the lumbar spine were normal. Patient sustained

On the statement of medical necessity per MG-2 form dated 07/13/16, patient has been experiencing severe lumbar spine pain/spasms since the injury. She complains of lumbar spine pain with cramps in the lower extremity going down to the feet, associated with tingling sensation. There is left greater than right L3-S1 pain and spasms, left greater than the right L3-4, L4-5 and L5-S1 facet joint pain, upon posterolateral extension at 45 degrees. There is bilateral sacroiliac joint tenderness. There is tenderness over the right lateral quadriceps muscle. Range of motion (ROM) is limited secondary to

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

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.

11/25/15 Progress Report described that the patient has moderate to severe pain in his lumbar spine. The pain is 5-6/10-scale level. It is radiating, to his right leg; associated with stabbing; aching and sharp. There is limited ROM due to pain, with stooping, bending, lifting, pushing, pulling, carrying, walking, standing, sitting, ascending and descending stairs. The patient reported difficulties performing his ADL. The patient also reported sleeping problems. The patient is not working since is injury. The patient is currently taking Advil 200 mg an ibuprofen. Exam of the lumbar spine revealed tenderness to palpation over the

DOI: 3/18/2016. Patient is a 31-year old female who sustained a work related injury to the lower back. The patient was subsequently diagnosed with strain of muscle, fascia and tendon of lower back, initial encounter. As per medical report dated 4/7/16, patient returns for recheck of injuries. The patient states she is not feeling better. Patient has been referred to physical therapy. On the review of system-musculoskeletal, back pain was noted. Lumbosacral spine shows tenderness at L2 to L5 at the left paraspinal (muscular, paraspinal L2, L3 and L4) and right paraspinal (muscular, paraspinal L2, L3 and L4).

Fracture or damage to the Lumbar vertebrae 5 may result into "foot drop with weakness of the anteriortibial, postiriortibial, loss of function by the peroneal muscle, and the damage to the sacral vertebrae 1 may result into weakness of the medial gastrocnemius muscle with impaired ankle planter flexion and loss of ankle

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