DOI: 05/21/2015. Patient is a 52-year-old male control operator who sustained an injury to his low back after lifting 42-pound rolls. Patient is diagnosed with lumbar isthmic spondylolisthesis, lumbar degenerative disc disease, lumbar foraminal stenosis, and lumbar radiculopathy. MRI of the lumbar spine dated 09/01/15 showed L5 to S1 pars defects with mild spondylolisthesis. There is a 4.5mm generalized disc bulging and redundancy of the disc annulus with impingement of existing L5 nerve roots at neural foraminal level, right greater than left. Per the medical report dated 09/29/16, patient complains of back pain, rated as 8/10, radiating to both lower extremities, worse with standing and walking. Per the medical report dated 11/10/16, the …show more content…
Patient has had progressive pain, numbness, and weakness in both lower extremities. He has had an epidural, physical therapy, and medications. It was reiterated that the patient has lost over 30 pounds. He has clear-cut instability as documented by the pars fracture and the spondylolisthesis, which is mobile on flexion/extension films. Per the appeal letter dated 12/09/16 by Dr. Deckey, the IW has an isthmic spondylolisthesis with foraminal stenosis and radiculopathy. MD argues that this patient does not warrant a psychosocial evaluation. He is a 52-year-old gentleman. He has lost weight, and he has gone through conservative treatment. A psychosocial evaluation is really an evaluation for patients who have degenerative lumbar disk disease and require surgery for degenerative disk disease. Obviously, there is a significant amount of psychological overlay in these patients. Patient has dynamic instability. He has radiculopathy. He has failed conservative treatment. He has attempted to lose weight and warrants a straightforward surgical
An MRI was performed of the lumbar spine. The examination found no significant extra
DOI: 4/16/2012. Patient is a 29-year-old male technician who sustained injury when he was 25-feet up on a ladder when the ladder slid and he fell onto the pavement. He had an open reduction internal fixation (ORIF x 2) for a compound tibia fibula fracture and had hardware removal in 4/25/2013. MRI of the lumbar spine performed on 3/24/2016 revealed L5-S1 small right paracentral disc protrusion without significant spinal canal stenosis or neuroforaminal narrowing.
QEP Scripts for Two Recordings – Audio for Musculoskeletal System; “OK, Team! We have a new patient in Room 3B who is being admitted with a progressive (gradual, advancing) decrease in mobility (movement) of his back and legs, and increase in pain located in the lumbosacral (lower back above the tailbone of the spine) area. The patient’s Primary Care Provider has sent along Computed Tomography scans (CT, a rotating x-ray emitter, detailed internal scanner) showing spinal stenosis (narrowing of the spine causing pressure on the nerves and spinal cord causing lower back pain.) and decrease of the normal lordosis (abnormal curvature lower spine, excessive inward curvature of the spine) in the thoracic vertebrae (upper and middle back). Lumbosacral
States I have bone disease, I had bilateral hip replacement. I need knee replacement. I can’t walk.” The record goes on to state “patient walked out prior to MSE with steady gait on
DOI: 08/29/2006. Patient is a 57-year-old male bookbinding operator/route salesman who sustained injury when he was startled by a cat while making a delivery and fell. Per OMNI, he was initially diagnosed with lumbar herniated disk. The patient is currently temporary totally disabled due to knee surgery in April 2013. Based on the progress report dated 03/21/16, the patient reports that his low back pain tweaked again, after making the bed.
DOI: 3/24/2010. The patient is a 55-year-old male machine shop lead who sustained back, neck, right shoulder and internal injuries due to repetitive work. As per medical report dated 04/27/16, the patient has a history of a spinal cord injury secondary to cervical stenosis. He underwent emergent decompressive cervical laminectomy on 3/26/10. The patient has ongoing neurogenic bowel, ongoing neurogenic bladder, severe depression and pain.
Introduction Diagnostics is one of the cornerstones of physiotherapy, in fact of medical and paramedical practice in general, and it constitutes the starting point for any possible treatment strategy. A diagnosis rarely provides complete certainty, and especially in primary care, making a diagnosis and determining variables that can be treated is difficult. During the course of the first consultation the physiotherapist will develop one hypothesis, or several, about possible diagnoses. Subsequently, this hypothesis (or hypotheses) will be tested. During such a first consultation, a patient will usually provide a history, indicating the symptoms they are experiencing and a request for help.
Alleged disability: Bipolar disorder, amputation of the left arm, and sleep apnea. He reported that he wore a prosthetic left arm most days. He had difficulty lifting objects and using the left upper extremity; he had a hook instead of hands and fingers. He also had difficulty concentrating because of anxiety.
Difficulties from spondylolysis plagued me for years in my teens. When the discomfort first began, I presumptuously told myself I remained tough enough to continue to play baseball through the pain; however, the soreness worsened, I needed to wear a back brace, and required several months of rest to heal. The downtime proved almost as painful as the injury itself. I felt well after this recovery period, except just as physical therapy ended, the achiness returned; a CT scan revealed not one, but two unhealed fractures that needed to be surgically repaired. During the weeks after surgery, I relied on a walker, and my pessimistic attitude caused many mental obstacles, one of which questioned my capability to be the athlete I was prior to my injury.
DOI: 8/15/2016. Patient is a 65-year-old male manager who sustained injury while he was lifting a tire that was lying flat on the ground when he slipped and felt a pull in his back. Per the procedure report dated 10/14/16, the patient had a lumbar trigger point injection. Based on the medical report dated 11/16/16, the patient complains of lower back pain which is sharp, dull and achy in nature. The lower back pain radiates to bilateral side, bilateral hips and bilateral legs.
Tests I would become very familiar with in the following years. They diagnosed me with pars defect at my 5th vertebrae of my lumbar spine and SI joint dysfunction. Essentially, I broke my lower back and had trauma to my pelvis. I damaged the archstone of my body; the thing holding me together was falling apart. I went through sleepless and painful nights.
The fact that bulging of the disc which leads to nerve entrapment and radiating pain resulting in a major shift of the medical world away from the Sacroiliac joint as the primary cause of ischaligia. Historically the period of 1950s in which scientist Solonen finalized his thesis on Sacroiliac joint is significant for spine research. In the previous decades the researchs and treatment has focused on the role of Sacroiliac joint as a major source of low back pain. One scientist Gardner (1950), concluded that some movement is necessary for the development and maintenance of the Sacroiliac joint.
More severe cases may present with scoliosis and respiratory compromise. Few reports have
9. Discussion There are different types of surgical method or techniques that have been developed in past years to achieve fusion and reduction for the deformity of isthmic spondylolisthesis, [52, 53, 59-62] but it is difficult to define the ideal surgical strategy for IS in adults based on the published data [65]. Each procedure has its own advantages and disadvantages; the basic principle of surgical treatment is decompression and stabilization. In various studies, some Surgeon [65, 66, 67] showed that in case of severe spondylolisthesis, it is better to fuse in situ then reduction procedure in the long bone. However, for slipped vertebrae extended at one or two level, usually fusion in situ is performed [65, 66, 68].
When this occurs, patients will commit to the care and treatment can be maximized when incorporated with scientific