Questions On Real Deal Or Gimmick Surgery?

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.

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.

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

MRI of the lumbar spine dated 07/30/15 demonstrated interval post-surgical change with removal of the disc extrusion at L4-5. There is residual granulation tissue versus broad-based left paracentral disc protrusion with left lateral recess stenosis.

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

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.

MRI scan of the lumbar spine with contrast dated 7/17/2015 showed compression of the descending left L5 nerve root at L5-S1 on the basis of a 6.1mm left paracentral disc extrusion and compression of the descending left L4 nerve root at L3-L4 on the basis of a 6mm left-sided pre-foraminal and foraminal disc extrusion.

In the summer between my sophomore and junior year, I had started to feel agonizing pain in my lower back. After seeing a specialist and going over the MRI, I was diagnosed with Lumbosacral Disc Disorder with Radiculopathy. Overall, the MRI revealed lumbar degeneration and congenital abnormalities of the lumbar spine with spondylolisthesis and instability. The problem causes low back pain with left leg weakness and numbness. The congenital abnormality of my spine was there since birth which is very rare; however, I do not have the most severe case compared to other people diagnosed with the same problem.

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.

2010). The patient history diagnosis is the first approach, sensation, reflexes and strength are examined, this is because sciatica is mainly diagnosed by its particular pain symptoms (Pullman-Mooar, 2013). The physical examination is dependent on neurological testing (Koes et al. 2007). If the pain is continual for more than six weeks after the patient history is taken, a physical examination will be completed (Pullman-Mooar, 2013). Imaging is used to distinguish if nerve root compression is visible initiated by a herniated disc (Jarvik et al. 2002). The Lasegue’s sign or most commonly known as the straight-leg-raising test is frequently used (Valat et al. 2010). A test conducted by Deville et al. 2000 demonstrates that the straight-leg-raising test has a sensitivity of 91% and a specificity of 26.4%, whereas the crossed straight-leg test has a sensitivity of 29% and a specificity of 88%. No tests have been conducted that have resulted in both a high sensitivity and a high specificity. Other diagnostic tests include the computed tomography (CT) scan and magnetic resonance imaging (MRI), which are used to diagnose physical defects that cause sciatica (Pullman-Mooar, 2013). As well as, electromyography, evoked potential testing, nerve conduction velocity testing and myelography. Yet, since the popularity of the MRI is increasing, myelography use is decreasing. Problems in

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

Lumbar Spinal Stenosis (LSS) affects a significant proportion of people in the population and can cause discomfort, limit activities of daily living, and can lead to significant disability. Even though numerous technological advancements have been made in the treatment of LSS, its management continues to be a challenge for both patients and healthcare professionals. Spinal Stenosis is a condition characterized by either narrowing of the spinal canal, also known as the Central Stenosis, or narrowing of the vertebral foramina (Delitto et al., 466). The combination effect of the loss of disc space, osteophytes, and hypertrophic lingamentum culminate to LSS (Genevay and Atlas 253). LSS is referred to as degenerative arthritis and the foraminal narrowing leads to a condition referred to as neurogenic claudication. Because of this narrowing, the spinal cord, and the spinal nerves are compressed thereby causing painful symptoms in the organs served by the affected nerves (Fishman 1141). Patients with this condition present with symptoms ranging from low back pain, general weakness decreased sensation to numbness of the limbs (Delitto et al., 467). Walking becomes a problem for people with this