Medical Case Study: Clinical Presentation

(3) spondylolishesis is the lumbar slippage of the vertebra between L4-L5 and L5 and S1 which causes the compression of the spinal nerves 4) degenerative joint disease related to aging is also responsible for the cause of sciatica, there is a malformation involvement in the spine and dehydration resulting to disc herniation and severe inflammation in the vertebral bodies causing the compression and irritation of the spinal nerve roots 4) degenerative joint disease related to aging is also responsible for the cause of sciatica . Sciatica evolves between the age of forty to sixty years old and commonly occurs more in male as compared to female (Fuller & Goodman, 2015). Also, genetic cause also plays a significant role in etiology aside from infection, the vast amount of load of the vertebral column causing the protuberance of the disc(Fuller & Goodman, 2015). Moreover, malignancy or arthritic spine within the vertebra or trauma implicates the cause of sciatic nerve irritation or compression (Fuller & Goodman,

Obtain a lumbar myelogram. If the myelogram confirms the disk herniation procedure with discectomy the following day.

Per medical report dated 01/23/15, the patient reported of middle and lower back pain and bilateral leg pain with tingling. He was diagnosed with thoracic compression fracture and lumbar spondylolisthesis.

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: 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

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

X-rays of the lumbar spine dated 11/6/2015 revealed mild loss of the disc heights at L4-L5 and posteriorly at L5-S1 level, consistent with degenerative disc disease. There are also anterior endplate osteophytes at

The herniation of the disc occurs when the nuclear tissue if forced out of the center portion of the disc. The tissue of the nucleus can cause the annulus to rupture when placed under an extreme amount of pressure. This pressure can be caused by a fall, car accidents, blunt force trauma, or degenerative condition. The pain that a patient feels from a herniated disc is most likely caused from the pressure that the nucleus places against spinal nerves.

Herniated discs are particularly brutal, due to their position directly behind the spinal cord. When a disc ruptures, the ‘jelly’ inside can spill out into the nerves. This results in severe pain that radiates through the back and sometimes down the legs, as in my case. For more than two years, it felt like I had a knife embedded in my lower back.

Roughly, 80% of the population will experience lower back pain once in their lifespan, while two-thirds of the population will experience neck pain. As ludicrous as it might appear, the ugly truth about slipped disc complications is that they are increasing at an alarming rate. Back pain and neck pain are the most common reasons of immobility in individuals under 45 years old. It is now very ubiquitous and not only found in elderly, or after a traumatic happening. A slipped disc can happen throughout the entire spine but is most common in the cervical and lumbar area. Inappropriate posture, unwarranted or protracted axial weight-bearing activities are the culprits; in other words, extended sitting or lifting and carrying of hulking objects that cause uneven distribution of weight across your spinal joint or the spinal discs. Over the time, axial loading (sitting or carrying weighty loads) can dehydrate your spinal disc. Dehydration of the

When it comes to herniated discs in the lumbar segment of the spine, there are multiple ways to manage symptoms of sciatica and motor weakness. As

Sciatica has been reviewed as having upwards of a ninety percent causal rate associated with a herniated disc causing compression of the nerve root in the lumbar region of the spine (Cook, 2014). While sciatica often has a favorable prognosis (two – four week improvement), it is often linked with higher disability, pain, and loss of function rates in comparison to lower back pain alone. Additionally, sciatica caused by herniation has been shown to decrease plantar and knee strength, leading to an increased risk of falling and difficulties with ADLs (activities of daily living) amongst seniors.

Age is one of the main factors that contribute to a person developing a herniated disc. As a person ages, the spine begins to contract and shrink. This causes the intervertebral discs to weaken and thin out, resulting in a herniated disc.

The most common type of non-specific musculoskeletal disorder is back pain. The most common type of specific musculoskeletal disorder is osteoarthritis. There are more than 100 types of arthritis, but osteoarthritis affects millions of people worldwide. Osteoarthritis (OA) is a form of arthritis and is a joint disease that occurs with wear and tear and aging. Back pain is categorized in three different episodes. They are either acute, sub-acute, or chronic. These episodes are broken up by duration and time frames. Acute back pain, which is the most common back pain, usually comes suddenly at a moments notice. They can often arise from bending over to pick something up and improper lifting, whether it’s lifting everyday objects or exercise equipment such as dumbbells and barbells. It can also occur due to tobacco use, lack of exercise, aging, and poor posture. A slipped disc, medically known as spinal disc herniation, is the most common acute back injury. A slipped disc is a very serious injury as it often leads to a condition known as Sciatica. Sciatica is a sharp pain that starts in the lower back and progresses to the front of the leg and may even reach the foot. 90% of sciatica cases are the result of a spinal disc herniation. In this event, one of the lumbar nerve or sacral nerve roots is pressed on by a slipped disc. Pressure on these nerves can cause tingling,

Summary of Background Data. Herniation disc is the situation in which the disc tears. The deterioration of the intervertebral disc has as a result the distraction of the architecture of the disc. As a result of the distraction of the disc that will lead to pain, limitation of movement or even to disability